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Update on the Use of Anti-VEGF Drugs in the Treatment of Retinopathy of Prematurity.
J Pediatr Ophthalmol Strabismus. 2020 Nov 01; 57(6):351-362.JP

Abstract

Retinopathy of prematurity (ROP) is one of the many significant consequences of premature birth and remains one of the leading causes of visual impairment in infants. Originally, cryotherapy was used to prevent the complications of vitreous hemorrhage and retinal detachment. Subsequently, laser photocoagulation, which is at least as effective and possibly safer than cryoretinopexy, was adopted as the primary treatment for type 1 ROP (stage 2 or 3 disease in zone II with plus disease or any stage disease in zone I with plus disease or stage 3 disease in zone I without plus disease). Laser therapy has been proven effective, and has a degree of permanence that is yet to be matched by alternative treatments, but can be associated with significant ocular side effects such as myopia. Treatment of type 1 ROP with anti-vascular endothelial growth factor (VEGF) agents seems to have fewer ocular side effects than laser ablation of the retina, particularly if used to treat type 1 ROP in zone I. However, ROP recurrence is a real threat after anti-VEGF therapy and long-term systemic side effects of this therapy remain under evaluation. This review focuses on the ophthalmic and systemic benefits and risks of anti-VEGF therapies for ROP as compared to retinal photocoagulation. Anti-VEGF therapies have dramatically altered the management of ROP and have also been shown to be beneficial with regard to the visual prognosis of patients with ROP, but patients so treated require frequent short- and long-term follow-up to detect and manage potential complications associated with this form of treatment. Such information also will allow clinicians to characterize the efficacy, side effect profile, and utility of intravitreal anti-VEGF agents for this condition. Prospective studies are needed to identify the optimum anti-VEGF drug and dose. [J Pediatr Ophthalmol Strabismus. 2020;57(6):351-362.].

Authors

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Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

33211892

Citation

Seery, Christopher W., et al. "Update On the Use of Anti-VEGF Drugs in the Treatment of Retinopathy of Prematurity." Journal of Pediatric Ophthalmology and Strabismus, vol. 57, no. 6, 2020, pp. 351-362.
Seery CW, Betesh S, Guo S, et al. Update on the Use of Anti-VEGF Drugs in the Treatment of Retinopathy of Prematurity. J Pediatr Ophthalmol Strabismus. 2020;57(6):351-362.
Seery, C. W., Betesh, S., Guo, S., Zarbin, M. A., Bhagat, N., & Wagner, R. S. (2020). Update on the Use of Anti-VEGF Drugs in the Treatment of Retinopathy of Prematurity. Journal of Pediatric Ophthalmology and Strabismus, 57(6), 351-362. https://doi.org/10.3928/01913913-20200824-02
Seery CW, et al. Update On the Use of Anti-VEGF Drugs in the Treatment of Retinopathy of Prematurity. J Pediatr Ophthalmol Strabismus. 2020 Nov 1;57(6):351-362. PubMed PMID: 33211892.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Update on the Use of Anti-VEGF Drugs in the Treatment of Retinopathy of Prematurity. AU - Seery,Christopher W, AU - Betesh,Saul, AU - Guo,Suqin, AU - Zarbin,Marco A, AU - Bhagat,Neelakshi, AU - Wagner,Rudolph S, PY - 2019/08/11/received PY - 2020/04/30/accepted PY - 2020/11/19/entrez PY - 2020/11/20/pubmed PY - 2021/8/11/medline SP - 351 EP - 362 JF - Journal of pediatric ophthalmology and strabismus JO - J Pediatr Ophthalmol Strabismus VL - 57 IS - 6 N2 - Retinopathy of prematurity (ROP) is one of the many significant consequences of premature birth and remains one of the leading causes of visual impairment in infants. Originally, cryotherapy was used to prevent the complications of vitreous hemorrhage and retinal detachment. Subsequently, laser photocoagulation, which is at least as effective and possibly safer than cryoretinopexy, was adopted as the primary treatment for type 1 ROP (stage 2 or 3 disease in zone II with plus disease or any stage disease in zone I with plus disease or stage 3 disease in zone I without plus disease). Laser therapy has been proven effective, and has a degree of permanence that is yet to be matched by alternative treatments, but can be associated with significant ocular side effects such as myopia. Treatment of type 1 ROP with anti-vascular endothelial growth factor (VEGF) agents seems to have fewer ocular side effects than laser ablation of the retina, particularly if used to treat type 1 ROP in zone I. However, ROP recurrence is a real threat after anti-VEGF therapy and long-term systemic side effects of this therapy remain under evaluation. This review focuses on the ophthalmic and systemic benefits and risks of anti-VEGF therapies for ROP as compared to retinal photocoagulation. Anti-VEGF therapies have dramatically altered the management of ROP and have also been shown to be beneficial with regard to the visual prognosis of patients with ROP, but patients so treated require frequent short- and long-term follow-up to detect and manage potential complications associated with this form of treatment. Such information also will allow clinicians to characterize the efficacy, side effect profile, and utility of intravitreal anti-VEGF agents for this condition. Prospective studies are needed to identify the optimum anti-VEGF drug and dose. [J Pediatr Ophthalmol Strabismus. 2020;57(6):351-362.]. SN - 1938-2405 UR - https://www.unboundmedicine.com/medline/citation/33211892/Update_on_the_Use_of_Anti_VEGF_Drugs_in_the_Treatment_of_Retinopathy_of_Prematurity_ L2 - https://journals.healio.com/doi/10.3928/01913913-20200824-02 DB - PRIME DP - Unbound Medicine ER -