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Comparison of fluorescein angiographic findings in type 1 and type 2 retinopathy of prematurity with intravitreal bevacizumab monotherapy and spontaneous regression

DOI:10.1007/s10792-018-01064-7 期刊:International Ophthalmology 出版年份:2019 更新时间:2025-09-23 15:23:52
摘要: Purpose To investigate the extent of vascularization of the peripheral retina and vascular development patterns in patients with type 1 retinopathy of prematurity (ROP) treated with intravitreal injection of bevacizumab (IVB) and compare fluorescein angiography (FA) findings of them to those seen in patients with type 2 ROP who have recovered spontaneously. Methods Between May 2014 and September 2016, patients with type 1 ROP who had a single 0.025 ml (0.625 mg) IVB were evaluated as study group. On the other hand, type 2 ROP patients with stage 2 or stage 3 ROP in zone II without plus disease on indirect ophthalmoscopy were not treated and included as a control group. The progression of ROP and vascularization of retina were evaluated by FA under sedation analgesia in all patients. Results Sixty-two eyes of 31 premature infants were included in the study: 36 eyes/18 patients were treated for type 1 ROP and 26 eyes/13 patients were followed conservatively with the diagnoses of type 2 ROP. In the last FA examination among the study group, vascular terminal was in zone II in 8 eyes/4 patients (22.22%) and in zone III in 28 eyes/14 patients (77.78%). Vascular terminal was in zone III in all eyes of the control group (100%). We noted circumferential vessels in 12 eyes/8 patients (33.3%) and 7 eyes/5 patients (26.92%) in the study and control groups, respectively. Abnormal branching was noticed in 13 eyes/7 patients (46.42%) in the control group, whereas it was not detected in the study group. Arteriovenous shunts were noted in 1 eye of a patient in the study group and in 5 eyes/4 patients in the control group. In 6 eyes/3 patients among the study group, we performed laser photocoagulation to the avascular retina because of profound vascular leakage. Conclusion Peripheral vascular abnormalities probably occur as a result of ROP itself because similar FA findings were detected both in type 1 and type 2 ROP patients with or without treatment, although significantly less in IVB-treated group. Retinal vascularization usually reaches the farthermost limits with time even though it slows down in eyes treated with IVB, indicating the importance of a longer follow-up.
作者: Asl? Vural,Fadime Ulviye Yi?it,Dilbade Y?ld?z Ekinci,Ismail Umut Onur,Gülsüm Oya Hergünsel
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To investigate the extent of vascularization of the peripheral retina and vascular development patterns in patients with type 1 ROP treated with intravitreal bevacizumab and compare fluorescein angiography findings to those in type 2 ROP patients who recovered spontaneously.

Peripheral vascular abnormalities are likely due to ROP itself, observed in both treated and untreated groups but less frequently in IVB-treated eyes. IVB slows vascularization but allows eventual full vascularization in most cases, reducing the need for additional laser therapy. Prolonged FA follow-up is important to avoid unnecessary treatments, with laser reserved only for cases with vascular leakage.

Retrospective study design may introduce bias. Small sample size (62 eyes). FA evaluation may not fully capture peripheral retina details. Follow-up times differed between groups, potentially affecting results. No long-term outcomes beyond the study period.

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