"Term infant brain MRI after ROP treatment by anti-VEGF injection versu" by Monica Manrique, Michael Pham et al.
 

Term infant brain MRI after ROP treatment by anti-VEGF injection versus laser therapy

Monica Manrique, Department of Ophthalmology; Children's National Hospital, Washington, DC.
Michael Pham, Department of Ophthalmology; Children's National Hospital, Washington, DC.
Sudeepta Basu, Department of Neonatology; Children's National Hospital, Washington, DC; The Developing Brain Institute, Children's National Hospital, Washington, DC; The George Washington University, Washington, DC. Electronic address: skbasu1@childrensnational.org.
Jonathan Murnick, The Developing Brain Institute, Children's National Hospital, Washington, DC; The George Washington University, Washington, DC; Department of Diagnostic Imaging and Radiology; Children's National Hospital, Washington, DC.
Md Sohel Rana, Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Hospital, Washington, DC.
Taeun Chang, Department of Neurology; Children's National Hospital, Washington, DC.
Christabel Chan, Department of Ophthalmology; Children's National Hospital, Washington, DC; The George Washington University, Washington, DC.
Emile Vieta-Ferrer, Department of Ophthalmology; Children's National Hospital, Washington, DC.
Catherine Sano, Department of Ophthalmology; Children's National Hospital, Washington, DC; The George Washington University, Washington, DC.
Catherine Limperopoulos, Department of Neonatology; Children's National Hospital, Washington, DC; The Developing Brain Institute, Children's National Hospital, Washington, DC.
Marijean Miller, Department of Ophthalmology; Children's National Hospital, Washington, DC; The George Washington University, Washington, DC; Department of Pediatrics; Children's National Hospital, Washington, DC.

Document Type

Journal Article

Publication Date

11-14-2024

Journal

Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus

DOI

10.1016/j.jaapos.2024.104038

Abstract

BACKGROUND: Intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF) agents is used to treat posterior type 1 retinopathy of prematurity (ROP). Recent reports indicate that anti-VEGF therapy may be associated with white matter brain injury, according to animal studies, and neurodevelopmental impairments in children born preterm. We investigated whether type 1 ROP treated with bevacizumab is associated with structural brain injury on infant term magnetic resonance images (MRIs) in very low birth weight infants compared with those treated with laser ablation. METHODS: We retrospectively reviewed the medical records of very low birth weight infants from 2006 to 2021 with type 1 ROP who had been treated with laser or anti-VEGF therapy. Intravitreal bevacizumab injection was used for type 1 ROP in zone 1 or very posterior zone 2 or when laser treatment was not feasible. A pediatric neuroradiologist reviewed brain MRIs at term equivalent age (36-46 weeks' postmenstrual age) and classified infants for severity (no/mild vs moderate/severe) of overall brain and white matter injury using the validated Kidokoro scoring system. RESULTS: Fifty-two infants met inclusion criteria: 35 (67%) treated with laser and 17 (33%) with bevacizumab. Moderate-to-severe brain injury scores were not statistically different between bevacizumab and laser treatment groups in either continuous or binary adjusted analyses, for either the overall score or the white matter subscore. CONCLUSIONS: Severity of structural injury on term brain MRI (total and white matter) did not differ between infants with type 1 ROP treated with anti-VEGF agent (bevacizumab) and those treated with laser ablation.

Department

Pediatrics

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