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Erschienen in:
10.01.2020 | Original Paper
Characteristics of ‘sawtooth shunt’ following anti-vascular endothelial growth factor for aggressive posterior retinopathy of prematurity
Erschienen in: International Ophthalmology | Ausgabe 4/2020
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Objective
To explore the characteristics of ‘sawtooth shunts (STS)’ following intravitreal anti-vascular endothelial growth factors (anti-VEGF) for aggressive posterior retinopathy of prematurity (AP-ROP).
Design
Prospective observational study.
Methods
In a prospective observational study, 45 eyes of 24 babies receiving intravitreal anti-VEGF for AP-ROP or hybrid ROP were analyzed. Anti-VEGF molecule and doses: bevacizumab (0.62 mg or ½ IVB, n = 30 eyes; 0.25 mg or 1/5IVB, n = 9 eyes; 0.12 mg or 1/10 IVB, n = 1 eye); or ranibizumab (0.25 mg or ½IVR, n = 3 eyes; 0.1 mg or 1/5IVR, n = 2 eyes). They were followed every 1–2 week till disease regression with or without laser treatment. Development of STS, its variants, characteristics, timeline, and final outcomes was analyzed.
Results
STS occurred in 26 (57.7%) eyes at 1–6 weeks following anti-VEGF injections and persisted for 1–14 weeks. While the shunt regressed spontaneously in half of the treated eyes (n = 13) with anti-VEGF alone, the other half (n = 13) required additional laser because of either non-compliance (n = 9) or recurrence (n = 4).
Conclusion
The STS was observed to be an important retinal vascular change seen in infants treated with intravitreal anti-VEGF at half adult doses. It warrants further studies to explore the association between STS and its association with disease recurrence or regression.