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The efficacy of intravitreal antivascular endothelial growth factor as primary treatment of retinopathy of prematurity: Experience from a tertiary hospital

H Kana, I Mayet, D Soma, H Dawood Alli, S Biddulph

Abstract


Background. Retinopathy of prematurity (ROP) is a vasoproliferative disease affecting premature babies and a major cause of blindness in childhood. Appropriate screening and treatment can prevent blindness.

Objective. To report on the efficacy of using antivascular endothelial growth factor (bevacizumab) as first-line therapy in ROP.

Methods. This was a retrospective analysis of patients with ROP treated at St John Eye Hospital, Johannesburg, South Africa, over a 3-year period. Outcome measures were the clinical response to intravitreal bevacizumab (IVB) as well as the economic impact of IVB therapy.

Results. Twenty-three patients were treated for active ROP or type 1 disease, in 44 eyes. Two patients required treatment in one eye only. The mean birth weight of these patients was 1 074 g (range 810 - 1 480). Response to treatment outcome was available for 22 patients (43 eyes). The mean follow-up period was 9 months (range 1 - 18). Forty-one eyes (95.3%) showed complete regression or non-progression of the disease. Two eyes (one eye each in two patients) progressed to advanced disease. There were no short-term adverse events. A cost-effective model showed that IVB treatment was much more economical than laser therapy.

Conclusion. IVB is a safe and effective first-line treatment for ROP and should be considered in resource-limited centres.


Authors' affiliations

H Kana, St John Eye Hospital-Chris Hani Baragwanath Academic Hospital and Department of Ophthalmology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

I Mayet, St John Eye Hospital-Chris Hani Baragwanath Academic Hospital and Department of Ophthalmology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

D Soma, St John Eye Hospital-Chris Hani Baragwanath Academic Hospital and Department of Ophthalmology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

H Dawood Alli, St John Eye Hospital-Chris Hani Baragwanath Academic Hospital and Department of Ophthalmology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

S Biddulph, St John Eye Hospital-Chris Hani Baragwanath Academic Hospital and Department of Ophthalmology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

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Keywords

Retinopathy of prematurity; Anti-VEGF therapy; Bevacizumab; Cost

Cite this article

South African Medical Journal 2017;107(3):215-218. DOI:10.7196/SAMJ.2017.v107i3.11080

Article History

Date submitted: 2017-02-27
Date published: 2017-02-27

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