Submitting/Presenting Author

Stephen DoxeyFollow

Abstract Type

Research

Primary Mentor

Dr. Michael Nyp

Start Date

13-5-2021 11:30 AM

End Date

13-5-2021 1:30 PM

Presentation Type

Poster Presentation

Description

Background: Retinopathy of prematurity (ROP) is a well-known complication occurring in the most premature infants leading to visual impairment and in the most severe cases associated with retinal detachment and childhood blindness. Factors contributing the development of ROP include chronic hypoxia and disordered vascular genesis primarily through the vascular endothelial growth factor (VEGF) signaling pathway. Infants at risk of developing ROP are screened with serial eye exam and treated with either laser surgery or intraocular injects of bevacizumab (Avastin) to prevent progression of ROP and preserve vision. Bevacizumab, an inhibitor of VEGF signaling, may have positive effects on preventing ROP but systemic inhibition of VEGF in the developing infants may worsen lung function and promote pulmonary hypertension associated with chronic lung disease of infancy (CLDI) and impair postnatal growth.

Objectives/Goal: To review our outcome of infants with severe ROP at risk of treatment to determine factors associated with laser surgery versus bevacizumab and assess for differences in growth and respiratory outcomes up to 24 months of age.

Methods/Design: Retrospective data collected from infants at risk of needing treatment for ROP treated at Children’s Mercy Kansas City. Data included maternal and birth demographics as well as respiratory status at time of treatment. Respiratory outcomes and growth parameters were collected up to 24 months of age. Subjects were divided into three groups based on whether they were treated with bevacizumab, laser surgery, or no treatment. Statistical analysis was performed X using SPSS 24 with continuous variable analyzed using Kruskal-Wallis Test (nonparametric data) and categorical data using ANOVA. P-value < 0.05 was consider significant.

Results: Please see attached tables for result. Infant demographic was similar between the three group with the group having laser surgery initially being small for gestational age, require positive pressure ventilation, and have pulmonary hypertension. However, the infants receiving laser surgery showed better growth parameters and less respiratory support at follow up.

Conclusions: Infants undergoing laser surgery for ROP appeared to initially have more severe lung disease but appear to have a potential benefit in respiratory function and growth at follow up.

MeSH Keywords

retinopathy of prematurity; bevacizumab; laser surgery; pulmonary hypertension

Additional Files

Outcomes of infants with severe ROP at risk of treatment with Ava.pdf (191 kB)
Abstract

Result tables for ROP study.xlsx (20 kB)
Result Tables for ROP Study

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May 13th, 11:30 AM May 13th, 1:30 PM

Outcomes of infants with severe ROP at risk of treatment with Avastin compared to laser surgery

Background: Retinopathy of prematurity (ROP) is a well-known complication occurring in the most premature infants leading to visual impairment and in the most severe cases associated with retinal detachment and childhood blindness. Factors contributing the development of ROP include chronic hypoxia and disordered vascular genesis primarily through the vascular endothelial growth factor (VEGF) signaling pathway. Infants at risk of developing ROP are screened with serial eye exam and treated with either laser surgery or intraocular injects of bevacizumab (Avastin) to prevent progression of ROP and preserve vision. Bevacizumab, an inhibitor of VEGF signaling, may have positive effects on preventing ROP but systemic inhibition of VEGF in the developing infants may worsen lung function and promote pulmonary hypertension associated with chronic lung disease of infancy (CLDI) and impair postnatal growth.

Objectives/Goal: To review our outcome of infants with severe ROP at risk of treatment to determine factors associated with laser surgery versus bevacizumab and assess for differences in growth and respiratory outcomes up to 24 months of age.

Methods/Design: Retrospective data collected from infants at risk of needing treatment for ROP treated at Children’s Mercy Kansas City. Data included maternal and birth demographics as well as respiratory status at time of treatment. Respiratory outcomes and growth parameters were collected up to 24 months of age. Subjects were divided into three groups based on whether they were treated with bevacizumab, laser surgery, or no treatment. Statistical analysis was performed X using SPSS 24 with continuous variable analyzed using Kruskal-Wallis Test (nonparametric data) and categorical data using ANOVA. P-value < 0.05 was consider significant.

Results: Please see attached tables for result. Infant demographic was similar between the three group with the group having laser surgery initially being small for gestational age, require positive pressure ventilation, and have pulmonary hypertension. However, the infants receiving laser surgery showed better growth parameters and less respiratory support at follow up.

Conclusions: Infants undergoing laser surgery for ROP appeared to initially have more severe lung disease but appear to have a potential benefit in respiratory function and growth at follow up.