Skip to main content

Advertisement

SpringerLink
Log in

Comparison of clinical outcomes of intravitreal ranibizumab and aflibercept treatment for retinopathy of prematurity

  • Retinal Disorders
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To compare the results of ranibizumab and aflibercept treatment in infants with treatment-requiring retinopathy of prematurity (ROP) in the posterior zone.

Methods

In this single-center, retrospective study, the records of the infants, who were treated between January 2015 and June 2017 in a tertiary center for screening and treatment of ROP, were reviewed. Infants who were administered ranibizumab or aflibercept as initial treatment and completed at least 1 year of corrected age were included. The patients were evaluated in terms of regression, progression or recurrence of the disease, vascularization of the peripheral retina, and ocular complication profile in early or late period.

Results

Fifty-four eyes of 27 infants who received ranibizumab treatment (ranibizumab group) and 72 eyes of 36 infants who received aflibercept treatment (aflibercept group) were enrolled. The rate of recurrence was 48.1% in ranibizumab group and 13.9% in aflibercept group. The mean recurrence times were at 8.2 ± 0.92 weeks following the injection of ranibizumab and at 14.2 ± 1.03 weeks following the injection of aflibercept. There were significant statistical differences between the groups in the rate of ROP recurrence, the time of recurrence, and the time of vascularization of peripheral retina (p = 0.001, p < 0.001, p < 0.001, respectively).

Conclusion

Although both ranibizumab and aflibercept are effective therapies for the treatment of ROP, more frequent and much earlier recurrences can be seen with ranibizumab treatment. Further studies are needed to obtain ideal options for the treatment of ROP.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Gilbert C, Muhit M (2008) Twenty years of childhood blindness: what have we learned? Community eye health / International Centre for Eye Health 21(67):46–47

    Google Scholar 

  2. Blencowe H, Lawn JE, Vazquez T, et al. (2010) Preterm-associated visual impairment and estimates of retinopathy of prematurity at regional and global levels for. PediatrRes 2013;74 Suppl 1:35–49

  3. Good WV, Early Treatment for Retinopathy of Prematurity Cooperative group (2004) Final results of the early treatment for retinopathy of prematurity (ETROP) randomized trial. Trans Am Ophthalmol Soc 102:233–248

    PubMed  PubMed Central  Google Scholar 

  4. Zhang G, Yang M, Zeng J et al (2016) Shenzhen Screening for Retinopathy of Prematurity Cooperative group. Comparison of intravitreal injection of Ranibizumab versus laser therapy for zone II treatment-requiring retinopathy of prematurity. Retina 37(4):710–717

    Article  CAS  Google Scholar 

  5. Mintz-Hittner HA, Kennedy KA, Chuang AZ (2011) Efficacy of intravitreal bevacizumab for stage 3+ retinopathy of prematurity. N Engl J Med 364:603–615

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Yetik H, Gunay M, Sirop S, Salihoglu Z (2014) Intravitreal bevacizumab monotherapy for type-1 prethreshold, threshold, and aggressive posterior retinopathy of prematurity - 27-month follow-up results from Turkey. Graefes Arch Clin Exp Ophthalmol 14:334–339

    Google Scholar 

  7. The section on Ophthalmology, American Academy of Pediatrics; American Academy of Ophthalmology (2013) American Association for Pediatric Ophthalmology and Strabismus. Screening examination of premature infants for retinopathy of prematurity. Pediatrics 131:189–195

    Article  Google Scholar 

  8. Martin DF, Maguire MG, Ying GS et al (2011) Ranibizumab and bevacizumab for neovascular age-related macular degeneration. N Engl J Med 364:1897–1908

    Article  CAS  PubMed  Google Scholar 

  9. International Committee for the Classification of Retinopathy of prematurity (2005) The international classification of retinopathy of prematurity revisited. Arch Ophthalmol 123:991–999

    Article  Google Scholar 

  10. Salman AG, Said AM (2015) Structural, visual and refractive outcomes of intravitreal aflibercept injection in high-risk prethresholdtype 1 retinopathy of prematurity. Ophthalmic Res 53(1):15–20. https://doi.org/10.1159/000364809

    Article  CAS  PubMed  Google Scholar 

  11. Alyamac Sukgen E, Çömez A, Koçluk Y, Cevher S (2016) The process of retinal vascularization after anti-VEGF treatment in retinopathy of prematurity:a comparison between Ranibizumab and bevacizumab. Ophthalmologica 236(3):139–147

    Article  CAS  PubMed  Google Scholar 

  12. Avery RL, Castellarin AA, Steinle NC et al (2014) Systemic pharmacokinetics following intravitreal injections of ranibizumab, bevacizumab or aflibercept in patients with neovascular AMD. Br J Ophthalmol 98:1636–1641

    Article  PubMed  Google Scholar 

  13. Wu WC, Shih CP, Lien R, Wang NK et al (2017) Serum vascular endothelial growth factor after bevacizumab or ranibizumab treatment for retinopathy of prematurity. Retina 37(4):694–701

    Article  CAS  PubMed  Google Scholar 

  14. Ferrara N, Damico L, Shams N et al (2006) Development of ranibizumab, an anti-vascular endothelial growth factor antigen binding fragment, as therapy for neovascular age-related macular degeneration. Retina 26:859–870

    Article  PubMed  Google Scholar 

  15. Erol MK, Coban DT, Sari ES et al (2015) Comparison of intravitreal ranibizumab and bevacizumab treatment for retinopathy of prematurity. Arq Bras Oftalmol 78:340–343

    PubMed  Google Scholar 

  16. Zehetner C, Kralinger MT, Modi YS et al (2015) Systemic levels of vascular endothelial growth factor before and after intravitreal injection of aflibercept or ranibizumab in patients with age-related macular degeneration: a randomized, prospective trial. Acta Ophthalmol 93:e154–e159

    Article  CAS  PubMed  Google Scholar 

  17. Papadopoulos N, Martin J, Ruan Q et al (2012) Binding and neutralization of vascular endothelial growth factor (VEGF) and related ligands by VEGF trap, ranibizumab, and bevacizumab. Angiogenesis 15:171–185

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Yi Z, Su Y, Zhou Y et al (2016) Effects of intravitreal Ranibizumab in the treatment of retinopathy of prematurity in Chinese infants. Curr Eye Res 41(8):1092–1097

    Article  CAS  PubMed  Google Scholar 

  19. Stewart MW, Rosenfeld PJ, Penha FM et al (2012) Pharmacokinetic rationale for dosing every2 weeks versus 4 weeks with intravitreal ranibizumab, bevacizumab, and aflibercept(vascular endothelial growth factor trapeze). Retina 32:434–457

    CAS  PubMed  Google Scholar 

  20. Hartnett ME (2014) Vascular endothelial growth factor antagonist therapy for retinopathy of prematurity. Clin Perinatol 41:925–943

    Article  PubMed  PubMed Central  Google Scholar 

  21. Warden SM, Andreoli CM, Mukai S (2007) The Wnt signaling pathway in familial exudative vitreoretinopathy and Norrie disease. Semin Ophthalmol 22:211–217

    Article  PubMed  Google Scholar 

  22. Sondell M, Lundborg G, Kanje M (1999) Vascular endothelial growth factor has neurotrophic activity and stimulates axonal outgrowth, enhancing cell survival and Schwann cell proliferation in the peripheral nervous system. J Neurosci 19:5731–5740

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Jin KL, Mao XO, Greenberg DA (2000) Vascular endothelial growth factor: direct neuroprotective effect in vitro ischemia. ProcNatl Acad Sci USA 97:10242–10247

    Article  CAS  Google Scholar 

  24. Saint-Geniez M, Maharaj AS, Walshe TE et al (2008) Endogenous VEGF is required for visual function: evidence for a survival role on Müller cells and photoreceptors. PLoS One 3(11):e3554

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Zhou Y, Jiang Y, Bai Y et al (2015) Vascular endothelial growth factor plasma levels before and after treatment of retinopathy of prematurity with ranibizumab. Graefes Arch Clin Exp Ophthalmol. https://doi.org/10.1007/S000417-015-2996-0

  26. Cam D, Berk AT, Micili SC et al (2016) Histological and Immunohistochemical retinal changes following the intravitreal injection of Aflibercept, bevacizumab, and Ranibizumab in newborn rabbits. Curr Eye Res 17:1–8

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Adana City Training and Research Hospital, Adana, Turkey

    Emine Alyamaç Sukgen & Yusuf Koçluk

  2. Adana Şehir Hastanesi, Kışla Mahallesi, Dr. Mithat Özhan Bulvarı/4522 Sok. No:1 Yüreğir, 01060, Adana, Turkey

    Emine Alyamaç Sukgen

Authors
  1. Emine Alyamaç Sukgen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yusuf Koçluk
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Emine Alyamaç Sukgen.

Ethics declarations

The study was approved by the Ethics Committee of the Hospital and complied with the tenets of the Declaration of Helsinki. Informed consent was obtained from the parents of all patients.

The authors did not receive any financial support from any public or private sources.

The authors have no financial or proprietary interest in any product, method or material described herein.

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study. The authors did not receive any financial support from any public or private sources. The authors have no financial or proprietary interest in a product, method, or material described herein.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sukgen, E.A., Koçluk, Y. Comparison of clinical outcomes of intravitreal ranibizumab and aflibercept treatment for retinopathy of prematurity. Graefes Arch Clin Exp Ophthalmol 257, 49–55 (2019). https://doi.org/10.1007/s00417-018-4168-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00417-018-4168-5

Keywords

Search

Navigation