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Aggressive Posterior Retinopathy of Prematurity Treated with Intravitreal Bevacizumab: Late Period Fluorescein Angiographic Findings

  • Retinal Disorders
  • Published:
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Abstract

Objective

To evaluate vascularization end limit of the peripheral retina and describe vascular development patterns of patients at the late period with aggressive posterior retinopathy of prematurity (APROP) who were treated with a single intravitreal injection of bevacizumab.

Methods

All patients were examined with RetCam III and fluorescein angiography (FA) within 90–100 gestational week. The vascularization end limit according to the zones and vascular structural abnormalities were noted.

Results

A total of 116 eyes of 58 patients were included. The mean gestational age and birth weight were 28.31 ± 2.5 (23–33) weeks and 1156.29 ± 386.38 (360–2300) g, respectively. The mean age at the time of FA was 95.09 ± 3.8 (90–100) weeks. According to the vascular termini, four eyes (3.4%) were in zone II posterior, 30 eyes (25.8%) were in zone II anterior, 22 eyes (18.9%) were in zone III with a distance of > 2 disc diameter (DD) from ora serrata, and 60 eyes (51.7%) were in zone III with a distance of < 2 DD from temporal ora serrata. Abnormal vascular findings were detected in 86.2% of patients (100/116 eyes) including circumferential vessels (43.1%), abnormal vascular branching (25.9%), closely packed vascular shunts (6.8%), and vascular leakage (10.3%).

Conclusion

FA gives us quantitative data for treatment decision at late period of APROP patients treated with bevacizumab. Fluorescein leakage and persistent avascular areas still detected at FA at 90–100 gestational weeks increase the risk for late complications. FA can detect the abnormalities that can not be detected via indirect ophthalmoscope and be useful for follow-up and further treatments of APROP.

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Authors and Affiliations

  1. Beyoglu Eye Educational and Research Hospital, Istanbul, Turkey

    Irfan Perente

  2. Bakirkoy Dr. Sadi Konuk Educational and Research Hospital, Istanbul, Turkey

    Erdem Eris & Zeynep Seymen

  3. Bursa High Speciality Educational and Research Hospital, Bursa, Turkey

    S. Gorkem Cevik

  4. Izmir S.B.U. Dr. Behcet Uz Child Diseases and Surgery Research and Training Hospital, Izmir, Turkey

    Sinan Bekmez

Authors
  1. Irfan Perente
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  2. Erdem Eris
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  3. Zeynep Seymen
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  4. S. Gorkem Cevik
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  5. Sinan Bekmez
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Contributions

IP, EE, ZS: conceived and designed the study; EE, ZS, SGC: were involved in patient care; KA, EE, SB: collected the data; EE, ZS, SB: analysis and interpretation of data; IP, EE: drafting the manuscript; EE: design of the work, revising the work critically for important intellectual content; all authors approved the final version of manuscript.

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Correspondence to Sinan Bekmez.

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The authors declare that they have no competing interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the national research committee with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Perente, I., Eris, E., Seymen, Z. et al. Aggressive Posterior Retinopathy of Prematurity Treated with Intravitreal Bevacizumab: Late Period Fluorescein Angiographic Findings. Graefes Arch Clin Exp Ophthalmol 257, 1141–1146 (2019). https://doi.org/10.1007/s00417-019-04292-4

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  • DOI: https://doi.org/10.1007/s00417-019-04292-4

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