title: Successful Surgical Management of Retinopathy of Prematurity Showing Rapid Progression despite Extensive Retinal Photocoagulation.
abstract: The management of retinopathy of prematurity (ROP) can be challenging in preterm babies with a gestational age <30 weeks, those with very low birth weight and multiple risk factors (eg., oxygen therapy for respiratory distress, sepsis, neonatal jaundice). A premature infant presented with "hybrid" zone 1 disease in the right eye and aggressive posterior ROP in the left eye. Both eyes were adequately treated with laser photocoagulation; however, the eyes deteriorated and progressed to stage 4 ROP. Both eyes eventually underwent intravitreal bevacizumab followed by lens sparing vitrectomy with good anatomical and visual outcome. Anticipation of progression despite laser photocoagulation in certain clinical scenarios, frequent follow-up and timely surgical intervention is paramount.
authors.affiliation: Department of Vitreoretina, PBMA's H.V. Desai Eye Hospital, Pune, Maharashtra, India.
authors.forename: Salil S
authors.initials: SS
authors.lastname: Gadkari
authors.affiliation: Department of Vitreoretina, PBMA's H.V. Desai Eye Hospital, Pune, Maharashtra, India.
authors.forename: Sucheta R
authors.initials: SR
authors.lastname: Kulkarni
authors.affiliation: Department of Vitreoretina, PBMA's H.V. Desai Eye Hospital, Pune, Maharashtra, India.
authors.forename: Rushita R
authors.initials: RR
authors.lastname: Kamdar
authors.affiliation: Department of Vitreoretina, PBMA's H.V. Desai Eye Hospital, Pune, Maharashtra, India.
authors.forename: Madan
authors.initials: M
authors.lastname: Deshpande
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000068258:Bevacizumab; D003131:Combined Modality Therapy; D018450:Disease Progression; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D058449:Intravitreal Injections; D017075:Laser Coagulation; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D010102:Oxygen Inhalation Therapy; D012178:Retinopathy of Prematurity / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab
keywords: Aggressive posterior retinopathy of prematurity; Hybrid form of retinopathy of prematurity; Lens Sparing Vitrectomy; Retinal Laser Photocoagulation