Der Ophthalmologe

, Volume 109, Issue 12, pp 1189–1197 | Cite as

Aktuelle Therapieoptionen bei Frühgeborenenretinopathie

Leitthema

Zusammenfassung

Die Frühgeborenenretinopathie ist eine der wenigen potenziell zur Erblindung führenden Netzhauterkrankungen des Kindesalters, bei der eine Verhinderung des Sehverlusts durch adäquate und rechtzeitige Therapie möglich ist. Netzhautablative Verfahren wie die Laserkoagulation können die krankheitsursächliche „Vascular endothelial growth factor“ (VEGF)-Sekretion der avaskulären peripheren Netzhaut unterbinden. Eine Blockade der VEGF-Aktivität durch intravitreale Applikation VEGF-hemmender Medikamente hat sich in aktuellen klinischen Studien ebenfalls als wirksam erwiesen. Fortgeschrittene Erkrankungsstadien können den Einsatz chirurgischer Verfahren erforderlich machen. Kenntnisse der Indikationen und Techniken der verschiedenen aktuell zur Verfügung stehenden Therapieverfahren sind entscheidend für die optimale Versorgung der betroffenen Kinder.

Schlüsselwörter

Frühgeborenenretinopathie Laserkoagulation Bevacizumab Ranibizumab Vitrektomie 

Current therapeutic options in retinopathy of prematurity

Abstract

Retinopathy of prematurity is one of only few potentially blinding retinal diseases of infancy amenable to prevention of visual loss by appropriate and timely therapeutic measures. Retinal ablative therapies, such as laser coagulation eliminate the disease-causing secretion of vascular endothelial growth factor (VEGF) by the avascular peripheral retina. Blockage of VEGF activity by intravitreal administration of VEGF-inhibitory drugs has likewise proven effective in recent clinical studies. Advanced stages of the disease may require surgical intervention. Knowledge of indications and techniques of the different currently available treatment options is crucial to ensure an optimal visual outcome for the affected children.

Keywords

Retinopathy of prematurity Laser photocoagulation Bevacizumab Ranibizumab Vitrectomy 

Notes

Interessenkonflikt

Der korrespondierende Autor weist für sich und seine Koautoren auf folgende Beziehungen hin: (Kategorie 1: Unterstützung von Forschungsprojekten und klinischen Studien; Kategorie 2: Beratung, Honorare, Reisekosten). Tim U. Krohne (Kat. 1: Novartis; Kat. 2: Novartis); Sabine Aisenbrey (Kat. 1: Bayer Healthcare; Kat. 2: Novartis, Bayer Healthcare); Frank G. Holz (Kat. 1: Novartis, Bayer Healthcare, Alcon, GSK, Pfizer; Kat. 2: Novartis, Bayer Healthcare, Genentech, Alcon, GSK, Pfizer, Acucela, Ophthotec).

Literatur

  1. 1.
    Arevalo JF, Maia M, Flynn HW Jr et al (2008) Tractional retinal detachment following intravitreal bevacizumab (Avastin) in patients with severe proliferative diabetic retinopathy. Br J Ophthalmol 92:213–216PubMedCrossRefGoogle Scholar
  2. 2.
    Autrata R, Krejcirova I, Senkova K et al (2012) Intravitreal pegaptanib combined with diode laser therapy for stage 3+ retinopathy of prematurity in zone I and posterior zone II. Eur J Ophthalmol 22(5):687–694PubMedGoogle Scholar
  3. 3.
    Averbukh E (2005) The evidence supporting the early treatment for type 1 retinopathy of prematurity needs further evaluation. Arch Ophthalmol 123:406 (discussion 409–410)PubMedCrossRefGoogle Scholar
  4. 4.
    Banach MJ, Ferrone PJ, Trese MT (2000) A comparison of dense versus less dense diode laser photocoagulation patterns for threshold retinopathy of prematurity. Ophthalmology 107:324–327 (discussion 328)PubMedCrossRefGoogle Scholar
  5. 5.
    Carneiro AM, Costa R, Falcao MS et al (2012) Vascular endothelial growth factor plasma levels before and after treatment of neovascular age-related macular degeneration with bevacizumab or ranibizumab. Acta Ophthalmol 90:e25–e30PubMedCrossRefGoogle Scholar
  6. 6.
    Choi J, Kim JH, Kim SJ et al (2011) Long-term results of lens-sparing vitrectomy for stages 4B and 5 retinopathy of prematurity. Korean J Ophthalmol 25:305–310PubMedCrossRefGoogle Scholar
  7. 7.
    Compernolle V, Brusselmans K, Acker T et al (2002) Loss of HIF-2alpha and inhibition of VEGF impair fetal lung maturation, whereas treatment with VEGF prevents fatal respiratory distress in premature mice. Nat Med 8:702–710PubMedGoogle Scholar
  8. 8.
    Cryotherapy for Retinopathy of Prematurity Cooperative Group (1988) Multicenter trial of cryotherapy for retinopathy of prematurity. Preliminary results. Arch Ophthalmol 106:471–479CrossRefGoogle Scholar
  9. 9.
    Deutsche Ophthalmologische Gesellschaft, Retinologische Gesellschaft, Berufsverband der Augenärzte Deutschlands (2012) Stellungnahme zum Einsatz von Bevacizumab in der Therapie der Frühgeborenenretinopathie. Ophthalmologe 109:197–204Google Scholar
  10. 10.
    Early Treatment For Retinopathy of Prematurity Cooperative Group (2003) Revised indications for the treatment of retinopathy of prematurity: results of the early treatment for retinopathy of prematurity randomized trial. Arch Ophthalmol 121:1684–1694CrossRefGoogle Scholar
  11. 11.
    Engle WA (2004) Age terminology during the perinatal period. Pediatrics 114:1362–1364PubMedCrossRefGoogle Scholar
  12. 12.
    European MAE (2007) Lucentis: scientific discussion (March 14, 2007). http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Scientific_Discussion/human/000715/WC500043550.pdf (Zugegriffen: 21.10.2011)Google Scholar
  13. 13.
    Hairston RJ, Maguire AM, Vitale S et al (1997) Morphometric analysis of pars plana development in humans. Retina 17:135–138PubMedCrossRefGoogle Scholar
  14. 14.
    Hardy RJ, Good WV, Dobson V et al (2004) Multicenter trial of early treatment for retinopathy of prematurity: study design. Control Clin Trials 25:311–325PubMedCrossRefGoogle Scholar
  15. 15.
    Hartnett ME, Maguluri S, Thompson HW et al (2004) Comparison of retinal outcomes after scleral buckle or lens-sparing vitrectomy for stage 4 retinopathy of prematurity. Retina 24:753–757PubMedCrossRefGoogle Scholar
  16. 16.
    Hashimoto T, Zhang XM, Chen BY et al (2006) VEGF activates divergent intracellular signaling components to regulate retinal progenitor cell proliferation and neuronal differentiation. Development 133:2201–2210PubMedCrossRefGoogle Scholar
  17. 17.
    Hinz BJ, Juan E de Jr, Repka MX (1998) Scleral buckling surgery for active stage 4A retinopathy of prematurity. Ophthalmology 105:1827–1830PubMedCrossRefGoogle Scholar
  18. 18.
    Hoerster R, Muether P, Dahlke C et al (2012) Serum concentrations of vascular endothelial growth factor in an infant treated with ranibizumab for retinopathy of prematurity. Acta Ophthalmol [Epub ahead of print]Google Scholar
  19. 19.
    Hu J, Blair MP, Shapiro MJ et al (2012) Reactivation of retinopathy of prematurity after bevacizumab injection. Arch Ophthalmol 130:1000–1006PubMedCrossRefGoogle Scholar
  20. 20.
    International Committee for the Classification of Retinopathy of Prematurity (2005) The international classification of retinopathy of prematurity revisited. Arch Ophthalmol 123:991–999CrossRefGoogle Scholar
  21. 21.
    Jandeck C, Kellner U, Lorenz B et al (2008) Guidelines for ophthalmologic screening of premature infants. Ophthalmologe 105:955–963PubMedCrossRefGoogle Scholar
  22. 22.
    Krohne TU, Eter N, Holz FG et al (2008) Intraocular pharmacokinetics of bevacizumab after a single intravitreal injection in humans. Am J Ophthalmol 146:508–512PubMedCrossRefGoogle Scholar
  23. 23.
    Krohne TU, Liu Z, Holz FG et al (2012) Intraocular pharmacokinetics of ranibizumab following a single intravitreal injection in humans. Am J Ophthalmol 154:682–686PubMedCrossRefGoogle Scholar
  24. 24.
    Laws DE, Haslett R, Ashby D et al (1994) Axial length biometry in infants with retinopathy of prematurity. Eye (Lond) 8(Pt 4):427–430Google Scholar
  25. 25.
    Lorenz B (2011) Kommentar: Anti-VEGF-Einsatz gut abwägen. Klin Monatsbl Augenheilkd 225:488–490Google Scholar
  26. 26.
    Lorenz B, Spasovska K, Elflein H et al (2009) Wide-field digital imaging based telemedicine for screening for acute retinopathy of prematurity (ROP). Six-year results of a multicentre field study. Graefes Arch Clin Exp Ophthalmol 247:1251–1262PubMedCrossRefGoogle Scholar
  27. 27.
    Lu JF, Bruno R, Eppler S et al (2008) Clinical pharmacokinetics of bevacizumab in patients with solid tumors. Cancer Chemother Pharmacol 62:779–786PubMedCrossRefGoogle Scholar
  28. 28.
    Martin DF, Maguire MG, Fine SL et al (2012) Ranibizumab and bevacizumab for treatment of neovascular age-related macular degeneration: two-year results. Ophthalmology 119:1388–1398PubMedCrossRefGoogle Scholar
  29. 29.
    Matsuyama K, Ogata N, Matsuoka M et al (2010) Plasma levels of vascular endothelial growth factor and pigment epithelium-derived factor before and after intravitreal injection of bevacizumab. Br J Ophthalmol 94:1215–1218PubMedCrossRefGoogle Scholar
  30. 30.
    Mintz-Hittner HA, Kennedy KA, Chuang AZ (2011) Efficacy of intravitreal bevacizumab for stage 3+ retinopathy of prematurity. N Engl J Med 364:603–615PubMedCrossRefGoogle Scholar
  31. 31.
    Moshfeghi DM, Berrocal AM (2011) Retinopathy of prematurity in the time of bevacizumab: incorporating the BEAT-ROP results into clinical practice. Ophthalmology 118:1227–1228PubMedGoogle Scholar
  32. 32.
    Muether PS, Kribs A, Hahn M et al (2012) No advanced retinopathy of prematurity stages 4 or 5 in a large high-risk German cohort. Br J Ophthalmol 96:400–404PubMedCrossRefGoogle Scholar
  33. 33.
    Ng EY, Connolly BP, McNamara JA et al (2002) A comparison of laser photocoagulation with cryotherapy for threshold retinopathy of prematurity at 10 years: part 1. Visual function and structural outcome. Ophthalmology 109:928–934 (discussion 935)PubMedCrossRefGoogle Scholar
  34. 34.
    Palmer EA, Hardy RJ, Dobson V et al (2005) 15-year outcomes following threshold retinopathy of prematurity: final results from the multicenter trial of cryotherapy for retinopathy of prematurity. Arch Ophthalmol 123:311–318PubMedCrossRefGoogle Scholar
  35. 35.
    Patel CK, Walker NJ, Kam JK (2010) A new, theoretically safer method of intravitreal injection of bevacizumab in progressive retinopathy of prematurity using scleral trans-illumination. Br J Ophthalmol 94:1107–1109PubMedCrossRefGoogle Scholar
  36. 36.
    Prenner JL, Capone A Jr, Trese MT (2004) Visual outcomes after lens-sparing vitrectomy for stage 4A retinopathy of prematurity. Ophthalmology 111:2271–2273PubMedCrossRefGoogle Scholar
  37. 37.
    Sato T, Wada K, Arahori H et al (2012) Serum concentrations of bevacizumab (Avastin) and vascular endothelial growth factor in infants with retinopathy of prematurity. Am J Ophthalmol 153:327–333PubMedCrossRefGoogle Scholar
  38. 38.
    Sears JE, Sonnie C (2007) Anatomic success of lens-sparing vitrectomy with and without scleral buckle for stage 4 retinopathy of prematurity. Am J Ophthalmol 143:810–813PubMedCrossRefGoogle Scholar
  39. 39.
    Section on Ophthalmology American Academy of Pediatrics, American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus (2006) Screening examination of premature infants for retinopathy of prematurity. Pediatrics 117:572–576CrossRefGoogle Scholar
  40. 40.
    Seiberth V, Linderkamp O, Vardarli I (1997) Transscleral vs transpupillary diode laser photocoagulation for the treatment of threshold retinopathy of prematurity. Arch Ophthalmol 115:1270–1275PubMedCrossRefGoogle Scholar
  41. 41.
    Wilkinson AR, Haines L, Head K et al (2009) UK retinopathy of prematurity guideline. Eye (Lond) 23:2137–2139Google Scholar
  42. 42.
    Zepeda-Romero LC, Liera-Garcia JA, Gutierrez-Padilla JA et al (2010) Paradoxical vascular-fibrotic reaction after intravitreal bevacizumab for retinopathy of prematurity. Eye (Lond) 24:931–933Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  1. 1.Universitäts-Augenklinik BonnBonnDeutschland
  2. 2.Universitäts-Augenklinik TübingenTübingenDeutschland

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