title: Laser-ranibizumab treatment for retinopathy of prematurity in umbral-preumbral disease. Three years of experience.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Laser-ranibizumab treatment has allowed a better control of retinopathy for threshold-prethreshold and "plus disease" in this group of patients.
authors.affiliation: Servicio de Oftalmología, Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, México, DF, Mexico. luisporozco@prodigy.net.mx
authors.forename: Luis Porfirio
authors.initials: LP
authors.lastname: Orozco-Gómez
authors.forename: Leonor
authors.initials: L
authors.lastname: Hernández-Salazar
authors.forename: Silvia
authors.initials: S
authors.lastname: Moguel-Ancheita
authors.forename: María Adela
authors.initials: MA
authors.lastname: Ramírez-Moreno
authors.forename: María Verónica
authors.initials: MV
authors.lastname: Morales-Cruz
mesh_terms: D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D018450:Disease Progression; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D008607:Intellectual Disability / Q000150:complications; D058449:Intravitreal Injections; D017075:Laser Coagulation; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D011596:Psychomotor Disorders / Q000150:complications; D000069579:Ranibizumab; D012171:Retinal Vessels / Q000473:pathology; D012178:Retinopathy of Prematurity / Q000150:complications / Q000188:drug therapy / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D016896:Treatment Outcome; D014664:Vasodilation
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D000069579:Ranibizumab