Abstract
Purpose
To report the results of scleral buckling (SB) with or without photocoagulation (PC) and intravitreal bevacizumab (IVB) for stage 4 retinopathy of prematurity (ROP) eyes.
Methods
Forty-two eyes of 28 patients with SB and/or PC or IVB were studied. Twenty-nine eyes had stage 4A and 13 eyes had stage 4B ROP. Seventeen eyes underwent SB combined with additional intraoperative or postoperative treatments (combined group). Twenty-five eyes underwent SB without additional therapy (non-combined group). The concentrations of vascular endothelial growth factor (VEGF) in the aqueous humor determined by enzyme-linked immunosorbent assay were compared between the two groups. The initial and final reattachment rates were also compared.
Results
The gestational age and birth weight were 25.0 ± 2.0 weeks and 786 ± 222 g in the combined group, and 25.5 ± 2.1 weeks and 899 ± 315 g in the non-combined group. The postmenstrual age at the time of initial surgery was 38.0 ± 1.9 in the combined and 44.1 ± 4.0 weeks in the non-combined group (P < 0.001). The initial reattachment rate was 92 % in stage 4A and 75 % in stage 4B of ROP eyes in the combined group, and the rate was 93 % in stage 4A and 33 % in stage 4B of ROP eyes in the non-combined group. The mean VEGF concentration in aqueous humor was 1923 ± 779 pg/ml in the combined group and 985 ± 303 pg/ml in the non-combined group (P < 0.05).
Conclusion
Our results show that the retinal reattachment rate after combined therapy was comparable to that in the non-combined group. We conclude that combined therapy may be effective even in ROP eyes with high activity.
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Acknowledgments
The authors thank Professor Duco Hamasaki of the Bascom Palmer Eye Institute of the University of Miami for his critical discussion and final manuscript revision. This work was supported by JSPS KAKENHI Grant Number 23390401.
Conflicts of interest
Y. Futamura, None; T. Asami, None; N. Nonobe, None; S. Kachi, None; Y. Ito, None; Y. Sato, None; M. Hayakawa, None; H. Terasaki, None.
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Futamura, Y., Asami, T., Nonobe, N. et al. Buckling surgery and supplemental intravitreal bevacizumab or photocoagulation on stage 4 retinopathy of prematurity eyes. Jpn J Ophthalmol 59, 378–388 (2015). https://doi.org/10.1007/s10384-015-0401-5
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DOI: https://doi.org/10.1007/s10384-015-0401-5