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Anti-VEGF shows promise in treatment of ROP, but safety concerns remain
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MILAN — Intravitreal ranibizumab might be an effective option in the treatment of stage 3+ retinopathy of prematurity and have a better safety profile compared with bevacizumab, according to a study.
“The use of anti-VEGF as a treatment strategy for ROP has raised considerable interest in recent years. In the BEAT-ROP trial, bevacizumab (Avastin, Genentech) showed superior outcomes and a lower recurrence rate compared to laser in zone 1 disease,” Marcel Menke, MD, said at the Euretina congress.
Marcel Menke
However, safety concerns were expressed about the potential systemic side effects of the drug.
“We started a new study with ranibizumab (Lucentis, Genentech/Novartis), a drug that is approved, has a shorter intravitreal half-life and has been shown to have a higher safety profile compared to bevacizumab,” Menke said.
Six eyes of four children were treated with half the dose of ranibizumab that is normally used in adults. Five months after injection, five eyes showed normal, complete vascularization. One eye remained without vascularization in zone 3 but showed no recurrence of ROP.
A potential complication of the anti-VEGF injection procedure is the increase in IOP, which occurred in three cases in the study. Menke recommended performing a paracentesis before injection to prevent this.
“Up to now children are doing well, but ROP recurrence occurs significantly later than it does with laser treatment,” he said.
The overall safety of anti-VEGF use in premature children is still a matter of controversy, and large studies are needed to assess it.