Occult retinal neovascularization following intravitreal bevacizumab and laser treatment for retinopathy of prematurity.
Humans
Retinopathy of Prematurity
Bevacizumab
/ therapeutic use
Intravitreal Injections
Infant, Newborn
Angiogenesis Inhibitors
/ therapeutic use
Female
Laser Coagulation
/ methods
Retinal Neovascularization
/ etiology
Fluorescein Angiography
Antibodies, Monoclonal, Humanized
/ therapeutic use
Combined Modality Therapy
Occult neovascularization
Plus disease
Retinopathy of prematurity
Journal
BMC pediatrics
ISSN: 1471-2431
Titre abrégé: BMC Pediatr
Pays: England
ID NLM: 100967804
Informations de publication
Date de publication:
04 May 2024
04 May 2024
Historique:
received:
17
09
2023
accepted:
22
04
2024
medline:
5
5
2024
pubmed:
5
5
2024
entrez:
4
5
2024
Statut:
epublish
Résumé
We present a patient with retinopathy of prematurity (ROP) who developed worsening plus disease after complete regression of stage 3 ROP. The use of fundus fluorescein angiography (FFA) aided the visualization of occult neovascularization that caused the disease progression. The patient was at high risk for ROP due to low birth weight of 690 g and gestational age of 25 weeks. After the diagnosis of stage 3 ROP in zone I without plus disease, she was treated initially with bilateral intravitreal bevacizumab (IVB) and followed by laser photocoagulation 5 weeks later. Despite the resolution of ROP stage, the plus disease worsened. Neither systemic risk factors nor skip laser areas were observed. Hence, FFA was performed and subsequently identified occult neovascularization with active leakage. Additional IVB and laser treatment in the capillary dropout area inside vascularized retina were added. The plus disease improved but mild arteriolar tortuosity persisted. Worsening of plus disease after completion of laser ablation and IVB with complete regression of stage 3 ROP is rare. Systemic risk factors such as continuous oxygen therapy and cardiovascular disease should be ruled out. FFA aided in identifying occult neovascularization and prompted further treatment.
Sections du résumé
BACKGROUND
BACKGROUND
We present a patient with retinopathy of prematurity (ROP) who developed worsening plus disease after complete regression of stage 3 ROP. The use of fundus fluorescein angiography (FFA) aided the visualization of occult neovascularization that caused the disease progression.
CASE PRESENTATION
METHODS
The patient was at high risk for ROP due to low birth weight of 690 g and gestational age of 25 weeks. After the diagnosis of stage 3 ROP in zone I without plus disease, she was treated initially with bilateral intravitreal bevacizumab (IVB) and followed by laser photocoagulation 5 weeks later. Despite the resolution of ROP stage, the plus disease worsened. Neither systemic risk factors nor skip laser areas were observed. Hence, FFA was performed and subsequently identified occult neovascularization with active leakage. Additional IVB and laser treatment in the capillary dropout area inside vascularized retina were added. The plus disease improved but mild arteriolar tortuosity persisted.
CONCLUSIONS
CONCLUSIONS
Worsening of plus disease after completion of laser ablation and IVB with complete regression of stage 3 ROP is rare. Systemic risk factors such as continuous oxygen therapy and cardiovascular disease should be ruled out. FFA aided in identifying occult neovascularization and prompted further treatment.
Identifiants
pubmed: 38704544
doi: 10.1186/s12887-024-04784-1
pii: 10.1186/s12887-024-04784-1
doi:
Substances chimiques
Bevacizumab
2S9ZZM9Q9V
Angiogenesis Inhibitors
0
Antibodies, Monoclonal, Humanized
0
Types de publication
Journal Article
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
301Informations de copyright
© 2024. The Author(s).
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