Treatment For Retinopathy Of Prematurity With Intravitreal Aflibercept And Ranibizumab:A Retrospective Study

Purpose: To analyze the clinical outcomes of intravitreal aflibercept(IVA)and intravitreal ranibizumab(IVR)for the treatment of retinopathy of prematurity(ROP)retrospectively.Subjects and Methods: A retrospective analysis was performed on the files of infants who received IVA or IVR as initial treatment in the Department of Ophthalmology,Second Xiangya Hospital of Central South University between September 2014 and September 2021 with at least 6 months follow-up.These infants were divided into IVA group and IVR group by the initial intravitreal drugs.Clinical data including postprogression,ocular complications,and structural outcomes were recorded to evaluate the safety and effectiveness of drugs,and compare the single treatment success rate,recurrence rate,recurrence interval,rate of progression,and rate of additional treatment between the two groups.Results: A total of 55 infants(103 eyes)were enrolled in the study.25 infants(46 eyes)underwent IVA and 30 infants(57 eyes)underwent IVR.The mean gestational age(GA)of patients were 27.90±1.84 weeks in IVA group and 28.47±1.38 weeks in IVR group(P=0.196).The mean birth weight(BW)of patients were 1086.80±363.90 g in IVA group and1184.83±263.18 g in IVR group(P=0.252).The median postmenstrual age(PMA)of patients were 38.50 weeks in IVA group and 37.57 weeks in IVR group(P=0.149).The effective rate was 95.65% in IVA group and87.72% in IVR group(P=0.286).The single treatment success rate was93.48% in IVA group and 61.40% in IVR group(P < 0.001).The recurrence rate was 0 in IVA group and 21.05% in IVR group(P=0.001).The rate of progression was 4.35% in IVA group and 12.28% in IVR group(P=0.286).The rate of additional treatment was 6.52% in IVA group and 38.60% in IVR group(P<0.001).The mean recurrence interval was 9.17±2.68 weeks in IVR group.The mean postmenstrual age(PMA)at recurrence was 45.11±4.36 weeks in IVR group.There were significant statistical differences in the single treatment success rate,recurrence rate,and rate of additional treatment between these two groups.Eyes with recurrence or progression suffered from more severe ROP in the posterior zone(zone I ROP,A-ROP,and posterior zone II ROP)at baseline.There were no ocular complications related to intravitreal injections in both groups,and there was no statistical difference in the incidence of unfavorable structural outcomes between the two groups.Conclusion: IVA and IVR showed similar safety and effectiveness in the treatment of ROP.The single treatment success rate was higher in IVA group.Higher recurrence and retreatment rate were observed in IVR group.Further large prospective,randomized controlled studies are needed.