Neurodevelopmental outcomes of infants treated with ranibizumab for severe retinopathy of prematurity - A case matched comparison to laser photocoagulation
What:
Paper Presentation | Présentation d'article
Part of:
When:
2:00 PM, Sunday 3 Jun 2018
(10 minutes)
Where:
How:
Authors: Anna Ells, April Ingram, Alexander Platt, Patrick Mitchell
Author Disclosure Block: A. Ells: None. A. Ingram: None. A. Platt: None. P. Mitchell: None.
Abstract Body:
Purpose: Intravitreal anti-VEGF therapy for treatment of severe retinopathy of prematurity (ROP) has demonstrated promising results, however reports of the safety of this treatment, related to neurodevelopmental development are limited. We compared the neurodevelopmental outcomes of two groups of infants treated for severe retinopathy of prematurity with low dose, anti-VEGF, ranibizumab, or laser photocoagulation.
Study Design: Retrospective matched case study
Methods: This was a retrospective matched case study and included two groups of infants treated for Type 1 (ETROP) severe ROP with either laser photocoagulation or intravitreal injection of ranibizumab. Infants included in each group were matched for time of hospital admission, Scores for Neonatal Acute Physiology (SNAP II), gestational age (+/- 1 week), birthweight (+/- 100 grams), highest stage and lowest zone of ROP at time of treatment. Measures of neurodevelopmental outcome included the Cognitive, Language, Motor Bayley Scales of Infant and Toddler Development. The Gross Motor Function Classification System (GMFCS) for cerebral palsy was also included and presence of significant hearing deficits were noted. Neurodevelopmental outcomes for infants were obtained at 21 months chronological age and compared for the two groups.
Results: Forty infants were enrolled, 20 in each treatment group and matched for the defined criteria. Mean birthweight in the group treated with ranibizumab was 613.9g and 623.5g in laser photocoagulation group. Gestational age at birth was 24.65 weeks and 24.8 weeks for ranibizumab and laser groups respectively. At 21 months, neurodevelopmental outcomes were available for 35 of 40 infants, as four infants were lost to follow-up and one was deceased. There was no statistically significant difference in Bayley cognitive, language or motor scores between the two groups. Three patients in each group were diagnosed with cerebral palsy (GMFCS 5, 3, and 2 in ranibizumab group; GMFCS 5, 3 and 1 in laser group), and one patient in the laser treated group has a note hearing deficit, requiring a hearing aid.
Conclusions: Clinical evidence indicates that intravitreal anti-VEGF therapy can be as effective as laser photocoagulation in the treatment of severe ROP. Twenty one months after laser photocoagulation or intravitreal injection of ranibizumab for severe ROP, no significant differences in neurodevelopment were found.
Author Disclosure Block: A. Ells: None. A. Ingram: None. A. Platt: None. P. Mitchell: None.
Abstract Body:
Purpose: Intravitreal anti-VEGF therapy for treatment of severe retinopathy of prematurity (ROP) has demonstrated promising results, however reports of the safety of this treatment, related to neurodevelopmental development are limited. We compared the neurodevelopmental outcomes of two groups of infants treated for severe retinopathy of prematurity with low dose, anti-VEGF, ranibizumab, or laser photocoagulation.
Study Design: Retrospective matched case study
Methods: This was a retrospective matched case study and included two groups of infants treated for Type 1 (ETROP) severe ROP with either laser photocoagulation or intravitreal injection of ranibizumab. Infants included in each group were matched for time of hospital admission, Scores for Neonatal Acute Physiology (SNAP II), gestational age (+/- 1 week), birthweight (+/- 100 grams), highest stage and lowest zone of ROP at time of treatment. Measures of neurodevelopmental outcome included the Cognitive, Language, Motor Bayley Scales of Infant and Toddler Development. The Gross Motor Function Classification System (GMFCS) for cerebral palsy was also included and presence of significant hearing deficits were noted. Neurodevelopmental outcomes for infants were obtained at 21 months chronological age and compared for the two groups.
Results: Forty infants were enrolled, 20 in each treatment group and matched for the defined criteria. Mean birthweight in the group treated with ranibizumab was 613.9g and 623.5g in laser photocoagulation group. Gestational age at birth was 24.65 weeks and 24.8 weeks for ranibizumab and laser groups respectively. At 21 months, neurodevelopmental outcomes were available for 35 of 40 infants, as four infants were lost to follow-up and one was deceased. There was no statistically significant difference in Bayley cognitive, language or motor scores between the two groups. Three patients in each group were diagnosed with cerebral palsy (GMFCS 5, 3, and 2 in ranibizumab group; GMFCS 5, 3 and 1 in laser group), and one patient in the laser treated group has a note hearing deficit, requiring a hearing aid.
Conclusions: Clinical evidence indicates that intravitreal anti-VEGF therapy can be as effective as laser photocoagulation in the treatment of severe ROP. Twenty one months after laser photocoagulation or intravitreal injection of ranibizumab for severe ROP, no significant differences in neurodevelopment were found.
