Application of vessel endothelium growth factor inhibitor ranibizumab in complex therapy of retinopathy of prematurity

AIM: To conduct a retrospective study of the application of vessel endothelium growth factor inhibitor ranibizumab in complex therapy of retinopathy of prematurity in Ural State children`s ophthalmological center at State Autonomic Health Institution of the Sverdlovsk Region Multiprofile Clinical Medical Center «BONUM» in Yekaterinburg.

MATERIAL AND METHODS: The study included 17 patients (33 eyes). The gestation age was from 23 to 30 weeks (mean: 26.5±1.7 weeks), birth weight was from 600 to 1850 g (mean: 867±229 g). 8 patients (47%) had APROP, and 9 patients (53%) had ROP stage III, type 1, “plus disease.” Laser coagulation of the avascular areas of the retina as the start in ROP therapy was performed in three patients with APROP (4 eyes, 12.1%). Intravitreal injection of the anti-VEGF ranibizumab was performed in 17 patients (33 eyes), including patients with previous laser coagulation. The age of the patients at the time of injection was from 7.7 to 15.6 weeks (10.5±1.9 weeks), PCA from 32.3 to 39.6 weeks (37.0±1.8 weeks). Patients with stage IVa ROP (5 patients, 6 eyes) underwent 25G or 27G lens sparing vitrectomy.

RESULTS: As a result of the complex treatment of ROP, the following results were obtained: complete regression in 13 patients (28 eyes, 84.8%). Partial regression in two patients (2 eyes, 6.1%). ROP progression to stage V in two patients (3 eyes, 9.1%).

CONCLUSION: Complex treatment of severe stages of active ROP with laser treatment, IVI injections, ranibizumab, and vitrectomy made it possible to preserve vision in 90.9% of patients.