ABSTRACT
PURPOSE: The German Retina.net ROP registry and its Europe-wide successor, the EU-ROP registry, collect data from patients treated for ROP. This analysis compares input parameters of these two registries to establish a procedure for joint analyses of different registry data using exemplary datasets from the two registries. METHODS: Exemplary datasets from the two databases over a 1-year period each (German Retina.net ROP Registry, 2011, 22 infants; EU-ROP Registry, 2021, 44 infants) were compared. The parameters documented in the two databases were aligned and analysed regarding demographic parameters, treatment modalities, complications within first 24 h and retreatments. RESULTS: The current analysis showed that data can be aligned for joint analyses with some adjustments within the data structure. The registry with more detailed data collection (EU-ROP) needs to be reduced regarding granularity in order to align the different registries, as the registry with lower granularity determines the level of analyses that can be performed in a comparative approach. In the exemplary datasets, we observed that the overall most common ROP severity in both registries was zone II, 3+ (2011: 70.5%; 2021: 65%), with decreasing numbers of clock hours showing preretinal neovascularisations (2011: 10-12 clock hours in 29% of cases, 2021: 4-6 clock hours in 38%). The most prevalent treatment method was laser coagulation in 2011 (75%) and anti-VEGF therapy in 2021 (86.1%). Within the anti-VEGF group, all patients were treated with bevacizumab in 2011 and with ranibizumab in 2021. Retreatment rates were comparable in 2011 and 2021. CONCLUSION: Data from two different ROP registries can be aligned and jointly analysed. The analysis reveals a paradigm shift in treatment modalities, from predominantly laser to anti-VEGF, and within the anti-VEGF group from bevacizumab to ranibizumab in Germany. In addition, there was a trend towards earlier treatment in 2021.
Subject(s)
Ranibizumab , Retinopathy of Prematurity , Infant, Newborn , Infant , Humans , Bevacizumab/therapeutic use , Angiogenesis Inhibitors/therapeutic use , Vascular Endothelial Growth Factor A , Retinopathy of Prematurity/therapy , Intravitreal Injections , Retina , Laser Coagulation/methods , Registries , Gestational AgeABSTRACT
BACKGROUND: Retinopathy of prematurity (ROP) is one of the main reasons for childhood blindness. The number of infants requiring treatment, however, is low for individual centers. The Retina.net ROP registry has been founded to allow a joint analysis of treatment patterns and courses post treatment. OBJECTIVE: This paper reports treatment patterns over 5 years. MATERIAL AND METHODS: All infants born between January 2011 and December 2015 who were entered into the treatment registry by one of the 12 participating centers were analyzed. RESULTS: The data of 150 infants (292 eyes) were analyzed and ROP 3+ in zone II was the most prevalent treatment indication. Gestational age and birth weight remained stable over the years. The treatment patterns, however, changed with anti-VEGF treatment (bevacizumab or ranibizumab) accounting for only 10% of treated eyes in 2011 but for 56% and 30% in 2014 and 2015, respectively. Almost all eyes with AP-ROP or zone I disease received anti-VEGF treatment. Zone II disease was predominantly treated with laser photocoagulation. Recurrences were more common and appeared later in the anti-VEGF group compared to the laser group (23%/interval 60 days vs. 17%/interval 23 days). Perioperative complications were evenly distributed across treatment groups. CONCLUSION: The data in this analysis represent about 10-15% of treated infants in Germany. The results provide evidence for an increasing use of anti-VEGF agents for ROP. The data reflect a selection bias for anti-VEGF treatment in eyes with a more aggressive disease. This needs to be considered when interpreting data such as disease recurrence rates. The risk for late recurrences after anti-VEGF treatment is of particular clinical significance.
Subject(s)
Retinopathy of Prematurity , Angiogenesis Inhibitors , Germany , Gestational Age , Humans , Infant , Infant, Newborn , Intravitreal Injections , Laser Coagulation , Registries , Retina , Vascular Endothelial Growth Factor AABSTRACT
BACKGROUND: Intravitreal Bevacizumab has been used as adjunct treatment to diode laser cyclophotocoagulation and/or retinal photo-/cryocoagulation in eyes with neovascular glaucoma and is discussed to reduce intraocular pressure and rubeosis irides in addition. METHODS: This study investigated the drop of the intraocular pressure of 23 patients who were treated by a concomitant therapy consisting of retinal kryocoagulation, diode laser coagulation and intravitreal injection of Avastin(®) administered in one session. RESULTS: At the time of discharge patients exhibited a 55.1 % (19.7 mmHg) decrease in intraocular pressure and also a 48.7 % (17.4 mmHg) decrease in regard to follow-up results. Topical agents were not significantly decreased with 2.1 agents at the beginning of treatment and 1.9 at the time of discharge. Furthermore, the systemic administration of acetazolamide was reduced from 12 patients at the beginning to 2 patients at the time of discharge. In 21 cases the intraocular pressure returned to normal levels, whereas the other two patients were pain-free after treatment. CONCLUSION: With the administration of triple therapy, the intraocular pressure showed a significant reduction. There were no severe complications and the symptoms also were improved significantly.
Subject(s)
Angiogenesis Inhibitors/administration & dosage , Antibodies, Monoclonal, Humanized/administration & dosage , Cryosurgery , Glaucoma, Neovascular/therapy , Laser Therapy , Lasers, Semiconductor/therapeutic use , Aged , Bevacizumab , Combined Modality Therapy , Female , Humans , Injections, Intraocular , Intraocular Pressure/drug effects , Male , Retrospective StudiesABSTRACT
PURPOSE: The aim of this study was to make an evaluation of the frequency of intraoperative complications during Aqualase phacoemulsification and correlate it to different intraoperative pupil diameters and nuclear grades. METHODS: Aqualase phacoemulsification was performed in 23 eyes without retinal or optic disc pathology in 23 unselected patients (15 women and 8 men) who underwent out-patient cataract surgery. Nuclear grade, intraoperative pupil diameters and complications were recorded. The correlation of intraoperative complications with intraoperative pupil diameter and nuclear grade was determined using "Fisher's exact" test. RESULTS: The average age of our patients was 70.3 (+/- 12.5) years, the mean best spectacle-corrected visual acuity (BSCVA) preoperatively was 0.39 (+/- 0.15) and the mean BSCVA postoperatively was 0.79 (+/- 0.13). The mean aqua time was 3.11 s (+/- 1.55 s) with maximum nuclear sclerosis of up to grade 3 (mean nuclear sclerosis 1.9). The aqua time correlated with the nuclear sclerosis (r = 0.90). The mean intraoperative pupil diameter was 7.2 (+/- 0.7) mm. In 2 of 3 patients with an intraoperative pupil diameter of 6 mm, iris touch occurred intraoperatively. There were no other intra- or postoperative complications. The frequency of iris touch was statistically significantly higher for reduced pupil diameters (p = 0.01). The nuclear grade with a maximum of 3 was without statistical significance to iris touch frequency (p > 0.05). CONCLUSIONS: The number of iris traumas is significantly higher when the intraoperative pupil diameter is reduced. The iris should be protected in these cases. A prospective, randomised study should be performed to compare the number of intraoperative complications between ultrasound and Aqualase phacoemulsification.
