Intravitreal pegaptanib combined with diode laser therapy for stage 3+ retinopathy of prematurity in zone I and posterior zone II.
OBJECTIVE
To investigate efficacy of intravitreal injection of pegaptanib and laser photocoagulation for treatment of stage 3+ retinopathy of prematurity (ROP) affecting zone I and posterior zone II, and to compare the results in terms of regression, development of peripheral retinal vessels, and final structural outcome with conventional laser photocoagulation or combined with cryotherapy.


METHODS
In a prospective comparative study, 152 eyes with zone I, II posterior ROP 3+ (76 premature rabies), from 2009 to 2011, were included. Patients were randomly assigned to receive intravitreal pegaptanib (Macugen® 0.3 mg = 0.02 mL, Pfizer) with conventional diode laser photocoagulation in group 1 (68 eyes of 34 infants) or only laser therapy combined with cryotherapy in group 2 (84 eyes of 42 infants), bilaterally. The primary outcome of treatment success was defined as absence of recurrence of stage 3+ ROP. The mean follow-up after treatment was 19.3 months in group 1 and 21.5 months in group 2.


RESULTS
Final favorable anatomic outcome and stable regression of ROP at last control examination was noted in 89.7% of eyes in group 1 and 60.8 % of eyes in group 2. Regression of plus disease and peripheral retinal vessels development appeared significantly more rapidly in group 1. No recurrence of neovascularization (stage 3+ ROP) was identified in 85.4% of patients in group 1 and 50% of patients in group 2.


CONCLUSIONS
Results of this study support the administration of intravitreal pegaptanib as useful therapy in the management of stage 3+ ROP.
Department of Pediatric Ophthalmology, Faculty of Medicine, Masaryk University and Faculty Hospital Brno, Brno, Czech Republic. rautrata@fnbrno.cz
Rudolf
R
Autrata
Inka
I
Krejcírová
Katerina
K
Senková
Marie
M
Holoušová
Zdenek
Z
Doležel
Ivo
I
Borek
D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D052157:Aptamers, Nucleotide / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D017679:Cryotherapy; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D058449:Intravitreal Injections; D017075:Laser Coagulation; D054023:Lasers, Semiconductor / Q000627:therapeutic use; D008297:Male; D011446:Prospective Studies; D015861:Retinal Neovascularization / Q000517:prevention & control; D012171:Retinal Vessels / Q000473:pathology; D012178:Retinopathy of Prematurity / Q000145:classification / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors
D020533:Angiogenesis Inhibitors; D052157:Aptamers, Nucleotide; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; C495058:pegaptanib