A Systematic Review and Meta-Analysis on the Safety of Vascular Endothelial Growth Factor (VEGF) Inhibitors for the Treatment of Retinopathy of Prematurity

Laser photocoagulation is the current gold standard treatment for proliferative retinopathy of prematurity (ROP). However, it permanently reduces the visual field and might induce myopia. Vascular endothelial growth factor (VEGF) inhibitors for the treatment of ROP may enable continuing vascularizat...

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Bibliographic Details
Published in:PloS one 2015-06, Vol.10 (6), p.e0129383
Main Authors: Pertl, Laura, Steinwender, Gernot, Mayer, Christoph, Hausberger, Silke, Pöschl, Eva-Maria, Wackernagel, Werner, Wedrich, Andreas, El-Shabrawi, Yosuf, Haas, Anton
Format: Article
Language:English
Subjects:
Analysis
Angiogenesis Inhibitors - adverse effects
Angiogenesis Inhibitors - therapeutic use
Care and treatment
Complications
Eye
Eye (anatomy)
Growth factors
Humans
Infants
Inhibitors
Literature reviews
Macular degeneration
Meta-analysis
Myopia
Preservation
Quantitative analysis
Retina
Retina - drug effects
Retina - pathology
Retinopathy
Retinopathy of prematurity
Retinopathy of Prematurity - drug therapy
Retinopathy of Prematurity - pathology
Risk
Safety
Safety and security measures
Side effects
Studies
Vascular endothelial growth factor
Vascular Endothelial Growth Factor A - antagonists & inhibitors
Vascularization
Visual field
Visual fields
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Summary:Laser photocoagulation is the current gold standard treatment for proliferative retinopathy of prematurity (ROP). However, it permanently reduces the visual field and might induce myopia. Vascular endothelial growth factor (VEGF) inhibitors for the treatment of ROP may enable continuing vascularization of the retina, potentially allowing the preservation of the visual field. However, for their use in infants concern remains. This meta-analysis explores the safety of VEGF inhibitors. The Ovid Interface was used to perform a systematic review of the literature in the databases PubMed, EMBASE and the Cochrane Library. This meta-analysis included 24 original reports (including 1.457 eyes) on VEGF inhibitor treatment for ROP. The trials were solely observational except for one randomized and two case-control studies. We estimated a 6-month risk of retreatment per eye of 2.8%, and a 6-month risk of ocular complication without the need of retreatment of 1.6% per eye. Systemic complications were only reported as isolated incidents. VEGF inhibitors seem to be associated with low recurrence rates and ocular complication rates. They may have the benefit of potentially allowing the preservation of visual field and lower rates of myopia. Due to the lack of data, the risk of systemic side effects cannot be assessed.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0129383