Non-surgical treatment of stage 4A retinopathy of prematurity

BMC Ophthalmol. 2024 Apr 19;24(1):180. doi: 10.1186/s12886-024-03434-5.

Abstract

Background: Retinopathy of prematurity (ROP) is a major cause of visual impairment in premature infants, often requiring surgical interventions in advanced stages. This retrospective case series study investigates non-surgical management for Stage 4A ROP, specifically the use of combined laser therapy and intravitreal anti-vascular endothelial growth factor (VEGF) injections.

Methods: Ten eyes from five infants with Stage 4A ROP were treated with a combined laser and anti-VEGF approach. Comprehensive follow-up examinations were conducted to evaluate the treatment outcomes.

Results: The study demonstrated successful retinal attachment without complications, showcasing the efficacy and safety of this non-surgical method. A comparison with surgical interventions highlighted the potential benefits in terms of reduced adverse effects.

Discussion: This combined treatment emerges as a promising first-choice option for Stage 4A ROP, offering rapid regression without surgical intervention, particularly in early stages. However, larger randomized clinical trials are necessary to validate these findings and establish definitive guidelines for managing this complex condition.

Conclusion: Combined laser and anti-VEGF therapy proved to be an effective and safe non-surgical approach for Stage 4A ROP, with the potential to reduce the need for surgery, especially in its early presentation. Further research is required to confirm these findings and provide comprehensive recommendations for clinical practice.

Keywords: Anti-vascular endothelial growth factor (VEGF); Retinopathy of prematurity; Stage 4A ROP.

MeSH terms

  • Angiogenesis Inhibitors* / therapeutic use
  • Gestational Age
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature
  • Intravitreal Injections
  • Laser Coagulation / methods
  • Retinopathy of Prematurity* / drug therapy
  • Retinopathy of Prematurity* / surgery
  • Retrospective Studies
  • Vascular Endothelial Growth Factor A

Substances

  • Angiogenesis Inhibitors
  • Vascular Endothelial Growth Factor A