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Time to consider a new treatment protocol for aggressive posterior retinopathy of prematurity?
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
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2013 (English)In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 91, no 2, 170-175 p.Article in journal (Refereed) Published
Abstract [en]

Purpose: 

To discuss treatment modalities for aggressive posterior retinopathy of prematurity (AP-ROP).

Methods: 

The medical charts of all infants with AP-ROP at Uppsala University Hospital, Sweden, during a 2-year period (2009 and 2010) were reviewed. Eight infants (16 eyes) with a mean gestational age of 23.8 weeks and a mean birth weight of 592 g were treated with laser and/or intravitreal injections of bevacizumab (0.4 and 0.625 mg). RetCam photography was used to document the retinal appearance before and after treatment.

Results: 

All infants (16 eyes) had AP-ROP in zone I. Mean time at initial treatment was 34 weeks postmenstrual age. Two eyes (one infant) were only treated with laser, and six eyes (three infants) were treated with laser therapy or cryopexy and, because of lack of regression, with bevacizumab as salvage therapy. Eight eyes (four infants) were treated with a first-line bevacizumab injection and four of these eyes (two infants) with additional laser ablation for continued disease progression in zone II. Macular dragging occurred in one eye of one infant primarily treated with laser.

Conclusions: 

Given the high complication rate of the extensive laser treatment for zone I ROP, it is worth considering anti-vascular endothelial growth factor treatment as an alternative therapy. Further knowledge concerning side effects and long-term ocular and systemic outcome is warranted before this drug becomes general clinical practice.

Place, publisher, year, edition, pages
2013. Vol. 91, no 2, 170-175 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-189722DOI: 10.1111/j.1755-3768.2011.02351.xISI: 000315331800036PubMedID: 22268644OAI: oai:DiVA.org:uu-189722DiVA: diva2:582165
Available from: 2013-01-03 Created: 2013-01-03 Last updated: 2017-12-06Bibliographically approved

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Spandau, UlrichTomic, ZoranEwald, UweLarsson, EvaÅkerblom, HannaHolmström, Gerd

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