title: Efficacy of intravitreal injection of anti-vascular endothelial growth factor agents for stage 4 retinopathy of prematurity.
abstract: OBJECTIVE
  To investigate the efficacy of intravitreal injection of anti-vascular endothelial growth factor agents for Stage 4 retinopathy of prematurity.
  
  
  METHODS
  Retrospective case series study. The medical records of patients receiving intravitreal injection of anti-vascular endothelial growth factor agents for Stage 4 retinopathy of prematurity from January 2007 to May 2012 in Taipei Veterans General Hospital were reviewed.
  
  
  RESULTS
  A total of 13 eyes of 7 patients (3 boys and 4 girls) with Stage 4 retinopathy of prematurity were included. The mean gestational age and birth weight were 27.6 ± 2.6 weeks (range, 24.5-30.5 weeks) and 893.1 ± 293.2 g (range, 550-1422 g), respectively. The mean age at the time of injection was 38.2 ± 1.9 weeks (range, 36.0-41.5 weeks) postmenstrual age, and the mean follow-up period was 37.8 ± 19.5 months (range, 11.0-67.5 months). The active neovascularization regressed rapidly, and the anatomical outcomes were favorable in all patients. One eye developed recurrent retinal hemorrhage with localized retinal detachment 21 weeks after initial treatment, which resolved after a second injection. There were no ocular or systemic complications in these patients.
  
  
  CONCLUSIONS
  Intravitreal injection of anti-vascular endothelial growth factor agents may be effective as monotherapy or as supplement to failed laser treatment for patients with Stage 4 retinopathy of prematurity without additional surgical intervention. Further randomized controlled trials are necessary to compare the clinical efficacy and safety with other conventional interventions.
authors.affiliation: *Department of Ophthalmology, School of Medicine, National Yang-Ming University, Taipei, Taiwan; †Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan; ‡Department of Ophthalmology, Buddhist Tzu Chi General Hospital, Taipei, Taiwan; §Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan; and ¶Biomedical Electronics Translational Research Center, National Chiao Tung University, Hsinchu, Taiwan.
authors.forename: Hui-Chen
authors.initials: HC
authors.lastname: Cheng
authors.forename: Shui-Mei
authors.initials: SM
authors.lastname: Lee
authors.forename: Yi-Ting
authors.initials: YT
authors.lastname: Hsieh
authors.forename: Po-Kang
authors.initials: PK
authors.lastname: Lin
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000068258:Bevacizumab; D001724:Birth Weight; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D058449:Intravitreal Injections; D017075:Laser Coagulation; D008297:Male; D000069579:Ranibizumab; D012178:Retinopathy of Prematurity / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D000069579:Ranibizumab