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Spectral domain-optical coherence tomographic assessment of macular changes following anti-vascular endothelial growth factor therapy in patients with retinopathy of prematurity

Devrim Toslak Muhammet Kazim Erol.

Abstract
Aim: The purpose of this study was to investigate the effect of intravitreal ranibizumab (IVR) injection for type 1 and aggressive posterior retinopathy of prematurity (ROP) and to detect probable alterations in central foveal thickness, to analyze macular structural changes and to observe regression of ROP following IVR therapy.
Material and Methods: 40 eyes of 22 patients with type 1 or aggressive posterior ROP who received IVR injections and had macular spectral domain– optical coherence tomography (SD – OCT) images were included in the study. All eyes were scanned using a portable SD-OCT machine before treatment and 1st week, 1st month, 2nd month following IVR injection. All SD-OCT images were evaluated for central foveal thickness (CFT) and the development of cystoid macular edema (CME).
Results: Recurrence of plus disease was observed in 10 eyes of six patients after IVR injection. Interval time from initial injection to recurrence was between 7 and 10 weeks. Alterations in CFT and macular structure were observed in short term period following IVR injection for type I and APROP. CME was observed in all patients but at various times in their follow-up periods.
Conclusions: CME is a frequently seen finding in type I ROP and APROP. It might be a physiologic consequence of normal development of macula as well as part of pathologic process influenced by IVR injection. Even though recurrence rate of ranibizumab is higher than bevacizumab, we propose that ranibizumab may be a safer alternative agent than bevacizumab.

Key words: Retinopathy of Prematurity; Vascular Endothelial Growth Factor; Cystoid Macular Edema; Ellipsoid Zone; Photoreceptor.



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