gms | German Medical Science

24rd Annual Meeting of the German Retina Society

German Retina Society

17.06. - 18.06.2011, Aachen

Retinal debate: Is bevacizumab superior to laser coagulation in retinopathy of preamturity? – The CONs

Meeting Abstract

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  • Andreas Stahl - Universitäts-Augenklinik Freiburg
  • W. Lagrèze - Universitäts-Augenklinik Freiburg
  • H. Agostini - Universitäts-Augenklinik Freiburg

German Retina Society. 24th Annual Conference of the German Retina Society. Aachen, 17.-18.06.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11rg57

DOI: 10.3205/11rg57, URN: urn:nbn:de:0183-11rg577

This is the translated version of the article.
The original version can be found at: http://www.egms.de/de/meetings/rg2011/11rg57.shtml

Published: June 15, 2011

© 2011 Stahl et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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Background: Despite improved screening and treatment, retinopathy of prematurity (ROP) still represents one of the main reasons for acquired vision loss in children. It is thus imperative to further refine existing treatment protocols and explore new therapeutic approaches. In particular intravitreal VEGF inhibition has recently received growing attention.

Methods: The pathomechanistic principle of anti-VEGF treatment in ROP is investigated in the mouse model of oxygen-induced retinopathy (OIR) with regard to its effects on both retinal vessels as well as the developing neuronal tissue. The available clinical studies on VEGF-inhibtion in ROP are critically reviewed with regard to both treatment outcome and side effects.

Results: Intravitreal anti-VEGF treatment attenuates proliferative retinopathy both in animal models and human patients. The first clinical studies on anti-VEGF therapy in ROP are encouraging. However, based on the largest trial to date, the BEAT-ROP study, anti-VEGF treatment is superior to laser treatment only in cases of ROP stage 3+ zone I. Very little is known on the potential longterm side effects of VEGF inhibition in a developing eye.

Conclusion: VEGF inhibition in the proliferative stages of ROP is a pathomechanistically sensible concept. The question of possible longterm side effects, however, has not been addressed sufficiently. A possible superiority over laser treatment has only been found for defined stages and zones of ROP. Panretinal laser coagulation in conjunction with tight screening protocols thus still forms the foundation of ROP management. Pharmacological approaches, however, have the potential to develop into sensible treatment alternatives for select ROP patients.