Laser-ranibizumab treatment for retinopathy of prematurity in umbral-preumbral disease. Three years of experience

• Published in: Cirugia y cirujanos Vol. 79; no. 3; p. 207
• Main Authors: Orozco-Gómez, Luis Porfirio, Hernández-Salazar, Leonor, Moguel-Ancheita, Silvia, Ramírez-Moreno, María Adela, Morales-Cruz, María Verónica
• Format: Journal Article
• Language: English
• Published: Mexico 01-05-2011
• Subjects: Angiogenesis Inhibitors - administration & dosage; Angiogenesis Inhibitors - therapeutic use; Antibodies, Monoclonal, Humanized - administration & dosage; Antibodies, Monoclonal, Humanized - therapeutic use; Combined Modality Therapy; Disease Progression; Female; Gestational Age; Humans; Infant; Infant, Low Birth Weight; Infant, Newborn; Infant, Premature; Intellectual Disability - complications; Intravitreal Injections; Laser Coagulation; Male; Postoperative Complications - epidemiology; Prospective Studies; Psychomotor Disorders - complications; Ranibizumab; Retinal Vessels - pathology; Retinopathy of Prematurity - complications; Retinopathy of Prematurity - drug therapy; Retinopathy of Prematurity - pathology; Retinopathy of Prematurity - surgery; Retinopathy of Prematurity - therapy; Treatment Outcome; Vasodilation
• ISSN: 2444-054X

The "Early Treatment for Retinopathy of Prematurity Cooperative" reported a failure rate of 55.2% using laser in zone 1 for treatment of retinopathy of prematurity (ROP). We need to offer better alternatives for those patients. We undertook this study to evaluate the efficacy of combined laser-ranibizumab therapy for ROP with threshold-prethreshold and "plus disease" and to study development of the newborn.
This is a prospective, experimental, longitudinal and open study including newborns of either <32 weeks of gestation or with a birth weight <1500 g, with threshold-prethreshold retinopathy or "plus disease." The effect of treatment was analyzed and development of the newborn was determined.
We studied 34 eyes of 17 patients. Age at birth was 29.9 ± 2.6 weeks. Birth weight was 1,120 ± 253 g. The statistics demonstrated an important relationship between severity of retinopathy and early birth age, along with a high probability of threshold-prethreshold disease at 29.4 weeks of age or 1204 g birth weight. The Bayley scale reported normal development in 23.5% of cases, global retardation in 23.5%, psychomotor retardation but normal mental behavior in 29.4%, and mental retardation but normal psychomotor development in 23.5%. We demonstrated regression of retinopathy in all cases. Persistence of vascular tortuosity was present in 17.6% of cases without vascular dilatation, and vitreous membrane development was demonstrated in 11.7% of patients.
Laser-ranibizumab treatment has allowed a better control of retinopathy for threshold-prethreshold and "plus disease" in this group of patients.