Effects of ranibizumab on very low birth weight infants with stage 3 retinopathy of prematurity: A preliminary report

Background/PurposeTo report the effects of ranibizumab on very low birth weight (VLBW) infants with retinopathy of prematurity (ROP).MethodsA retrospective, noncomparative, consecutive, interventional case series was conducted. Patients with stage 3 ROP were identified and evaluated from August 2011 to February 2012. All patients with ROP received one intravitreal ranibizumab injection (0.25 mg/0.025 mL) under topical anesthesia as the initial treatment.Main outcome measures: Regression of ROP and the complications associated with the intravitreal ranibizumab injection.ResultsA total of 23 eyes of 12 patients (four boys and eight girls) were included in this study. All of the patients had a history of supplemental oxygen and mechanical ventilation use. The mean gestational age was 26.33 ± 2.06 weeks (range: 24–30 weeks), and the mean birth weight was 821.58 ± 297.63 g (range: 507–1480 g). The mean postmenstrual age during the intravitreal administration of ranibizumab injection was 35.08 ± 2.07 weeks (range: 32–39 weeks), and the mean follow-up period was 5.83 ± 1.64 months (range: 3–8 months). All eyes received one intravitreal ranibizumab injection (0.25 mg/0.025 mL) as the primary therapy. None of the eyes needed conventional laser photocoagulation or cryotherapy as adjuvant therapy and no systemic complications were noted. No cataracts, endophthalmitis, or retinal detachment occurred postoperatively. Preretinal hemorrhages were found in four eyes of three patients (17.39%), but all were absorbed without sequelae.ConclusionIntravitreal ranibizumab injections seem to be effective and well tolerated in VLBW infants with stage 3 ROP. Only self-limited preretinal hemorrhages were noted, and no short-term systemic or major ocular side effects were identified.