Incidence of Persistent Avascular Retina Post Intravitreal Injection of Ranibizumab for Retinopathy of Prematurity

Abstract Background Retinopathy of prematurity (ROP) is a vision threatening retinal disease caused by vascular proliferation in the immature retina of premature infants, the lower the gestational age and birth weight, the higher the chance of developing ROP. Aim of the Work Our study discuss the incidence of PAR after 6 months of follow up and the recurrence rate of retinopathy of prematurity (ROP) after treatment with intravitreal injection of ranibizumab. Patients and Methods 25 eyes of 13 patients with type 1 ROP and AROP underwent intravitreal injection of ranibizumab as an initial treatment between October 2021 and November 2022 were included in this study. Results Data of patients included GA, BW, age at initial injection (weeks), type of ROP, the recurrence rate of ROP and number of injections needed, incidence of PAR and if complete retinal vascularization occurred, the age at complete retinal vascularization (weeks) were analyzed, if FFA was done to assess leakage in areas of PAR and laser was done to the area of PAR. 11 eyes (44%) of the studied eyes had near complete vascularization at PMA of 45-66 weeks, and the remaining 14 eyes(56%) had PAR after 6 months of follow up after IVR injection. Recurrence occurred in three eyes (12%), one eye of them was injected twice and two eyes had three injections. Conclusion Screening for ROP should be taken seriously and should include all infants at risk of developing ROP to avoid visual complications. Recently the use of intravitreal injection of ranibizumab is effective in treating advanced ROP. The treatment with IVR lead to complete retinal vascularization at PMA 45-66 weeks. In case of PAR, FFA may be useful before applying laser to detect any vascular leakage in this avascular retina. Recurrence of ROP can occur during a period of 5-7 weeks after IVR injection, so long term follow up should be done for proper observation and management of any recurrence.