Comparison of bevacizumab, ranibizumab and aflibercept in retinopathy of prematurity treatment


Suren E., ÖZKAYA D. , Cetinkayan E., Kalayci M., Yigit K., Kucuk M. F. , ...More

INTERNATIONAL OPHTHALMOLOGY, 2022 (Journal Indexed in SCI) identifier identifier identifier

  • Publication Type: Article / Article
  • Publication Date: 2022
  • Doi Number: 10.1007/s10792-021-02188-z
  • Title of Journal : INTERNATIONAL OPHTHALMOLOGY
  • Keywords: Aflibercept, Bevacizumab, Ranibizumab, Retinopathy of prematurity, ENDOTHELIAL GROWTH-FACTOR, INTRAVITREAL AFLIBERCEPT, REFRACTIVE OUTCOMES, TYPE-1 RETINOPATHY, INJECTION, PRETHRESHOLD, MONOTHERAPY, RISK, EYES

Abstract

Purpose To compare the efficacy and refractive outcomes of intravitreal bevacizumab, ranibizumab and aflibercept in retinopathy of prematurity (ROP) treatment. Methods We analyzed the files of patients treated with intravitreal bevacizumab, ranibizumab and aflibercept for ROP, retrospectively. A total of 187 eyes of 111 patients were included. Recurrence time after initial treatment, recurrence rate, age and rate of additional treatment, refractive outcomes in age 1, 2 and 3 were evaluated and compared between the groups. Results Fifty-four eyes of 30 patients formed bevacizumab group (Group-1), 77 eyes of 47 patients formed ranibizumab group (Group-2) and 56 eyes of 34 patients formed aflibercept group (Group-3). No significant difference was found in gender, gestational age, birth weight and risk factors between the groups (p>0.05). Success rate was higher in group 3, but the difference was not significant (p = 0.174) (74.1% in group-1, 62.4% in group-2 and 76.8% in group-3). Recurrence rate was higher in group 2, but the difference was not significant (p = 0.158) (25.9% in group-1, 37.6% in group-2 and 23.2% in group-3). Recurrence time after initial treatment was significantly shorter in group 2 (p < 0.01). Additional treatment rate was also higher, and the age of additional treatment was lower in group-2 (p < 0.05 and p < 0.01, respectively). We found refractive values more myopic in ages of 1, 2 and 3 in group 1. Conclusions Bevacizumab, ranibizumab and aflibercept are effective treatment alternatives for ROP. We observed more frequent and much earlier recurrence in eyes treated with ranibizumab. A myopic shift was found in bevacizumab group. We also emphasize the necessity of longer follow-ups for infants treated with anti-VEGF drugs.