Abstract

SO.01.02

Intravitreal therapy of retinopathy of prematurity

Volker Seiberth
Marienhospital Osnabrück GmbH, Klinik für Augenheilkunde

Objective: The invent of VEGF blockers has revolutionized the therapy of retinal vascular desease. In a short period VEGF blocker therapy became the standard treatment in exsudative age related macular degeneration (AMD). To date in retinopathy of prematurity (ROP) laser coagulation is the therapeutic gold standard.
Methods: However, surprising results were reported after intravitreal application of VEGF blockers in stage 3 and stage 4 ROP (International Classification, ICROP). Usually one dose of the VEGF blocker is administered as mono therapy or in combination with laser coagulation. Bevacizumab (Avastin®) has theoretically some advantage when comparing with different VEGF blockers. Bevacizumab is commonly used in ROP treatment.
Results: Though a VEGF blocker is applicated intravitreously physiologic vascularisation progresses to the ora serrata while pathologic vessels of ROP disappear. Because of complete retinal vascularisation visual field loss which is mandatory after laser coagulation is not to be expected.
Conclusions: The use of VEGF blockers in ROP is to date off label. Thus, multiple and severe legal problems may arise. Long-term results are still missing. Systemic side effects have not been described. Controlled clinical trials are ongoing. Possibly, with the invent of VEGF blockers a new era of ROP treatment has started.

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