Conserved regression patterns of retinopathy of prematurity after intravitreal ranibizumab: A class effect

Marco H. Ji, Darius M. Moshfeghi, Ryan A. Shields, Zachary Bodnar, Cassie A. Ludwig, Natalia F. Callaway, Lorenzo Orazi, Giulia M. Amorelli, Domenico Lepore

Research output: Contribution to journalArticlepeer-review


Purpose: To determine if fluorescein angiographic (FA) findings after intravitreal ranibizumab (IVR) for retinopathy of prematurity (ROP) conform to a class effect previously described with bevacizumab. Methods: Single-center retrospective case series of all infants treated with 0.2 mg (0.02 mL) IVR for Type 1 ROP from July 2016 to November 2018. FA were obtained at 40, 52, 62, and 72 weeks of postmenstrual age (PMA) using wide-angle photography. FA images were analyzed and the peripheral avascular areas measured with ImageJ using a reference disc diameter (DD). Based on the extent of the avascular area and tortuosity of the retinal vessels all eyes were classified into four categories: complete vascular maturity (vascularization within 2 DD of the ora serrata), VAA (avascular area >2 DD of the ora serrata), VAT (avascular area >2 DD of the ora serrata and posterior tortuosity), and reactivation (recurrence of stage disease). Results: About 13 infants were enrolled and 24 eyes were available in this study. None of the eyes reached complete vascular maturity at an average PMA of 60 weeks, 7 (29%) eyes presented with VAA, 8 (33%) with VAT, and 9 (37.5%) reactivated. The reactivated eyes presented with the largest area of peripheral ischemia, followed by the VAT and then the VAA groups (p = 0.02). Conclusion: IVR conforms to the previously described regression patterns following intravitreal bevacizumab for ROP indicative of a class effect. Follow-up using FA might help to optimize the management of these infants after injection of the drug.

Original languageEnglish
JournalEuropean Journal of Ophthalmology
Publication statusAccepted/In press - 2020
Externally publishedYes


  • pediatric ophthalmology
  • pharmacology
  • retina
  • Retinopathy of prematurity
  • ROP
  • vitreous/retinal disease

ASJC Scopus subject areas

  • Ophthalmology


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