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Transpupillary laser versus intravitreal Anti‐ VEGF for the management of acute ROP : where do we stand?
Author(s) -
Lorenz B.
Publication year - 2017
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2017.04411
Subject(s) - medicine , bevacizumab , stage (stratigraphy) , ophthalmology , laser therapy , randomized controlled trial , surgery , laser , chemotherapy , paleontology , physics , optics , biology
Summary According to ETROP , treatment‐requiring ROP is any stage in zone I with plus, stage 3 in zone I without plus, and stage 2 + or 3 + in Zone II . Zone I disease and aggressive posterior ROP , APROP , still have reduced prognosis as to anatomical and functional outcome. The BEAT ‐ ROP study compared Anti‐ VEGF therapy with Bevacizumab and traditional transpupillary laser therapy to treat zone I and posterior zone II disease in a randomized fashion. Since then many other reports were published, mostly non‐randomized, and often not limited to zone I or posterior zone II disease. An important risk after anti‐ VEGF therapy are late recurrences due to persistent immature retinal vascularization. Optimal dosage is not yet known. Also, eventual long‐term negative effects on neurodevelopmental features have been reported. On the other hand less myopia with anti‐ VEGF than with laser is claimed as a possible advantage, and also the ease of application not needing anesthesia. From all data it would appear that APROP still remains a major challenge irrespective of the mode of treatment. This paper will discuss the pros and cons for the various treatment options.