Analysis Of Factors Influencing Multiple Anti-VEGF Treatments For Retinopathy Of Prematurity

Purpose:The development of anti-vascular endothelial growth factor(anti-VEGF)drugs has provided a new option for the treatment of retinopathy of prematurity(ROP).Currently,anti-VEGF drug therapy has become the preferred treatment for some types of ROP.However,some children with ROP require multiple anti-VEGF therapy,but the risk factors are unclear.In this study,we summarized the clinical data of children with ROP who underwent anti-VEGF treatment at the First Hospital of Jilin University from 2015 to 2020 to investigate the factors influencing the relapse of children with ROP after anti-VEGF treatment and the need for multiple anti-VEGF treatments.Methods:Retrospective analysis of ROP cases born between February 1,2015 and June 30,2020 at the First Hospital of Jilin University,treated with anti-VEGF,and regularly followed in the postoperative ophthalmology clinic.General data(sex,gestational age,birth weight,first preoperative corrected gestational age),fundus screening in children at different times(zone,stage,plus),gestational and perinatal data(mode of delivery,1-minute Apgar score,multiple pregnancies,assisted reproduction),comorbidities(neonatal sepsis,acute respiratory distress syndrome(ARDS),ductus arteriosus,bronchopulmonary dysplasia(BPD),intracranial hemorrhage,neonatal anemia),birth Routine blood data(white blood cell level,absolute neutrophil value,absolute lymphocyte value,absolute monocyte value,red blood cell level,hemoglobin,red blood cell volume,platelet level,platelet volume)within 24 hours after birth.The children were divided into single treatment group(1 time)and multiple treatment group(≥2 times)according to the number of anti-VEGF treatments.The risk factors for relapse after anti-VEGF treatment and the need for multiple anti-VEGF treatments in children with ROP were investigated by comparing and analyzing the relevant clinical data of the two groups.SPSS 20.0 software(IBM SPSS statistics20.0)was applied to statistically analyze the data,and p < 0.05 was considered a statistically significant difference.Results:1.A total of 83 ROP children with complete case data were included in this study.and their gestational age(GA)was 27.57±2.34 weeks,of which 53(63.9%)were GA < 28 weeks,26(31.3%)were GA < 32 weeks,and 4(4.8%)were GA≥32 weeks.birth weight(BW)1097.89±372.12 g,Among them,38 cases were BW < 1000g(45.8%),35 cases were1000g≤BW < 1500g(42.2%),8 cases were 1500≤BW < 2000g(9.6%),and 2 cases were BW > 2000g(2.4%).Single treatment group 57 cases(68.7%);Multiple treatment group 26 cases,accounting for 31.3%.GA and BW were 26.40±1.97 weeks and 926.73±374.44 g in the multiple treatment group.The gestational age was corrected before the first anti-VEGF treatment: 37.63±2.93 weeks in the single treatment group and 34.07±1.78 weeks in the multiple treatment group.2.Univariate analysis showed statistically significant differences in gestational age,birth weight,first preoperative corrected gestational age,first preoperative fundus lesion area,mode of delivery,assisted reproduction,neonatal sepsis,ARDS,ductus arteriosus,neonatal anemia,BPD,and absolute neutrophil values between the single-treatment group and the multi-treatment group(p<0.05).3.Binary logistic regression analysis showed that gestational age,birth weight,first preoperative corrected gestational age,first preoperative fundus lesion area,absolute neutrophil value,and BPD were independent risk factors for multiple anti-VEGF treatments in children with ROP.Conclusions:1.Gestational age,birth weight,first preoperative corrected gestational age,first preoperative fundus lesion area,mode of delivery,assisted reproduction,neonatal sepsis,ARDS,patent ductus arteriosus,neonatal anemia,BPD,and absolute neutrophil value were risk factors for recurrence after anti-VEGF treatment and the need for multiple anti-VEGF treatments in children with ROP.2.Gestational age,birth weight,first preoperative corrected gestational age,first preoperative fundus lesion area,absolute neutrophil value,and BPD were independent risk factors for the need of multiple anti-VEGF treatments in children with ROP.3.Children with ROP whose preoperative corrected gestational age was 34±1.78 weeks at the time of first anti-VEGF treatment and the first preoperative fundus lesion in zone I were at high risk for multiple anti-VEGF treatments,and the interval of fundus screening should be appropriately shortened after the first anti-VEGF treatment for these children.