Evaluating peripheral retinal vascularization and rate of recurrence after intravitreal injection of ranibizumab as a primary treatment for retinopathy of prematurity

Context Retinopathy of prematurity (ROP) is a vascular proliferative disease affecting premature infants. Aims The aim was to assess the extent of peripheral retinal vascular growth and recurrence rate in patients with type 1 ROP treated with ranibizumab. Settings and design Patients with ROP attending the pediatric eye clinic in the main university hospital in Alexandria Faculty of Medicine were recruited. Participants and methods This prospective study included 20 eyes of 10 patients showing type 1 ROP, treated with 0.25 mg ranibizumab intravitreal injection only. Patients were followed for 6 months, where peripheral vascularization and rate of recurrence were assessed through indirect ophthalmoscopy and RetCam imaging. Statistical analysis Data were fed to the computer and analyzed using IBM SPSS software package version 20.0. The tests used were χ2 test, Fisher’s exact test, and Student t test. Results A total of 16 (80%) eyes showed good peripheral vascularization and favorable anatomical outcome. The average timing for temporal zone III retinal vascularization was 15.71±2.09 weeks, with three eyes not reaching zone III after 6 months of injection. One eye showed retinal folding and macular ectopia. Three (15%) eyes showed signs of recurrence, with two eyes showing neovascularization at the initial vascular ridge by the fifth week after intravitreal ranibizumab injection (IVR), and one eye showing the recurrence of thick temporal ridge by the fourth months. Conclusions Ranibizumab is a potential effective treatment for patients with type 1 ROP. Delayed peripheral vascularization and disease recurrence mandate tailored long-term follow-up period according to individual response.