Researchers continue to study role of anti-VEGF in management of ROP

CHICAGO — Anti-VEGF intravitreal injections may play a future role in treating retinopathy of prematurity, according to a speaker here.

“The BEAT-ROP study has brought a lot of attention to [intravitreal bevacizumab] for the treatment of retinopathy of prematurity,” Michael Trese, MD, said at Retina Subspecialty Day preceding the joint meeting of the American Academy of Ophthalmology and Asia-Pacific Academy of Ophthalmology.

Michael Trese

The prospective, randomized clinical trial compared intravitreal Avastin (bevacizumab, Genentech) and vitrectomy with conventional laser therapy and vitrectomy in patients with either zone 1 or zone 2 ROP.

There were no differences between laser therapy and anti-VEGF treatment for zone 2 disease, but there were significant differences between laser and anti-VEGF for zone 1 disease, in favor of anti-VEGF, Trese said.

The difference in results can be attributed to both the population of the study and the laser failure rate for zone 1 disease, which was 42%, according to Trese.

“The population of the study was 67% Hispanic, which is a more difficult ROP to treat, but may not accurately represent the ethnic makeup of the United States or much of the rest of the world,” he said. “These two elements are important in understanding the results of the study.”

Trese said the study was not powered to assess side effects or safety. Seven deaths occurred during the study; five of the infants had received intravitreal bevacizumab, and two had received laser therapy.

“Anti-VEGF treatment for ROP will most likely have a role in ROP management, but until convincing safety data is available, the right drug and the right dose is in question,” he said.

Disclosure: Trese is a consultant for FocusROP, Genentech, NuVue Technologies, Retinal Solutions LLC and ThromboGenics, as well as part equity owner of FocusROP, NuVue Technologies, Retinal Solutions LLC and ThromboGenics. He receives patent royalties from Synergetics.