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Intravitreal bevacizumab, ranibizumab, or aflibercept for ROP treatment?

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A new study compared the efficacy and refractive outcomes of patients with retinopathy of prematurity (ROP) treated with intravitreal bevacizumab, ranibizumab, and aflibercept.

Researchers analyzed data from 187 eyes (111 patients) with ROP, including 54 eyes (30 patients) treated with bevacizumab; 77 eyes (47 patients) treated with ranibizumab; and 56 eyes (34 patients) treated with aflibercept.

There were no significant differences in gender, gestational age, birth weight, and risk factors between the 3 groups (P > 0.05).

Patients treated with aflibercept had a success rate of 76.8%, compared with 74.1% in patients treated with bevacizumab and 62.4% in patients treated with ranibizumab; the difference was not significant. The recurrence rate was higher in patients treated with ranibizumab (37.6%), but there was no significant difference between the bevacizumab group (25.9%) and the aflibercept group (23.2%).

Patients treated with ranibizumab had a significantly shorter recurrence time after the initial treatment (P < 0.01); in addition, the additional treatment rate was higher, and the age of additional treatment was lower in this group.

The authors concluded that each of the 3 treatments are effective alternatives for ROP, but suggested that longer follow-up periods are needed for infants with ROP treated with anti-VEGF drugs.

Süren E, Özkaya D, Çetinkaya E, et al. Comparison of bevacizumab, ranibizumab and aflibercept in retinopathy of prematurity treatment. Int Ophthalmol. 2022;doi: 10.1007/s10792-021-02188-z. Epub ahead of print. PMID: 35094229.