Outcome Of Ranibizumab Treatment In Patients With Retinopathy Of Prematurity

Purpose:To study the application and outcome of Ranibizumab treatment in retinopathy of prematurity(ROP)patients and the factors that influenced it.Methods:This retrospective case series collected consecutive infants treated with Ranibizumab for ROP from January 2012 to August 2015.Patients who received Ranibizumab as primary treatment were classified as group 1;patients who received ranibizumab as pre-vitrectomy adjunctive treatment were classified as group 2.Group 1 patients were classified into five subgroups:cured,recurrence,incomplete vascularization,no response and deteriorated group.Regression was analyzed according to gestational age(GA),birth weight(BW),postmenstrual age(PMA)at treatment and ROP type.Results:There were 286 eyes in group 1,mean GA was 29.3±2.1 weeks,mean BW was 1395.8±413.4g,mean PMA at treatment was 36.0±2.3 weeks.There were 131 eyes(45.8%),127 eyes(44.4%),8 eyes(2.8%),1 eye(0.3%)and 16 eyes(5.6%)in cure,recurrence,incomplete vascularization,no response and deteriorated subgroup respectively.The mean recurrence time was 8.3±2.7 weeks after ranibizumab injection.In deteriorated subgroup,2 eyes progressed to Stage 4A,5 eyes to Stage 4B,4 eyes to Stage 5 and the rest 5 eyes had severe posterior fibrosis.In group 1,48.3%eyes received additional laser treatment,2.8%eyes received surgery and 3.1%eyes had both laser treatment and surgery.At last visit,5 eyes(1.7%)had retinal detachment and the rest eyes(98.3%)had flat retina.In group 2,there were 26 eyes,mean GA was 29.4±1.7 weeks,mean BW was 1336.9±308.0g,mean PMA at ranibizumab treatment was 40.9±2.8 weeks,mean duration from vitrectomy to injection was 6.2±7.5 weeks.Seven eyes of Stage 4A and one eye of Stage 4B were observed regression of ROP after injection without the need for subsequent vitrectomy.The retinal reattachment rate in Stage 4 was 92.3%and was 38.5%in Stage 5 ROP.The main ocular complication observed in this study was vitreous or preretinal hemorrhage,cataract,and vessel sheathing.No notable systemic complications were observed.The mean follow-up time of group 1 and group 2 were 13.0±8.5 months and 12.9±9.2 months.Conclusion:Ranibizumab injection is effective in treating prethreshhold ROP and some Stage 4 patients.Besides,it can use as pre-vitrectomy treatment.GA and ROP type were factors which influenced the outcome.