Comparison of treatment results of intravitreal injection of BEVACIZUMAB and AFLIBERCEPT in retinopathy of prematurity treatment

Abstract

Retinopathy of preterm infants is the most common treatable cause of blindness in developed and developing countries in premature infants. Vascular endothelial growth factor (VEGF) plays a very important role in the pathogenesis of this disease and many studies have examined and confirmed the effectiveness of anti-inflammatory drugs such as bevacizumab and ranibizumab in the treatment of this disease. The aim of the present study was to compare the therapeutic effect of aflibercept and bevacizumab in the treatment of retinopathy of preterm infants. Materials and Methods: In this cross-sectional study, 143 eyes of neonates who underwent injection of anti-VEGF drugs (bevacizumab and aflibercept in charity hospital during 1397 due to ROP) were examined. In terms of initial response to treatment, disease recurrence rate and need for laser therapy, retinal vascularization completion time and refractive error rate at one year were statistically compared based on case findings. With the decrease of at least one stage in the disease was defined. The recurrence of the disease was defined as the increase of at least one stage in the disease or recurrence of Plus disease (Plus disease was defined as the presence of tortuosity and engorgement of the posterior retinal arteries). Results: In both groups, the sex ratio of male and female patients was almost equal and this variable had no effect on study evaluations. A total of 143 eyes were examined, of which 73.4% were in the bevacizumab group and 26.6% were in the aflibercept group. Age at birth was 28.53±2.12 weeks in the bevacizumab group and 28.89±2.02 weeks in the aflibercept group. Comparison of the results of response to treatment in the study patients showed that all patients in both groups had an appropriate response to anti-VEGF injection; In contrast, the recurrence rate after injection was 5.6%. Significantly, the recurrence rate was higher in patients in the aflibercept group than in bevacizumab group (15.8% vs. 1.9%; p=0.005). Significantly, the mean time to complete retinal vascularization was higher in the aflibercept group compared to the bevacizumab group (8.87±1.51 vs. 5.57±2.18 months; p=0.001). Evaluation of refractive error in improved neonates showed that in both groups most patients had hyperopia, which was more than one diopter.