Retinopathy of prematurity risk predictors in peripheral avascular areas after intravitreal ranibizumab treatment: Vascular outgrowth speed analysis

Abstract

Abstract Objective To explore the predictors of risk for peripheral avascular areas (PAR) in retinopathy of prematurity (ROP) after intravitreal ranibizumab (IVR) monotherapy Methods This retrospective study included 64 infants (118 eyes) who developed type 1 ROP and received IVR between July 2019 and March 2021. Retinal vascular outgrowth speed (RVOS) was assessed by measuring the disc diameter (DD) 2 months post-IVR. Potential risk factors were examined and recorded. Logistic regression analysis and receiver operating characteristic (ROC) curves were used to determine risk factors and predict PAR values. Results Mean RVOS was 0.9 ± 0.6 DD/month in all eyes 2 months post-IVR; RVOS in treated eyes was higher than in non-treated eyes. Completed retinal vascularization was detected in 69 (58.5%) eyes, persistent PAR in 49 eyes (41.5%). Univariate logistic regression analysis showed that gestational age at birth, postnatal age (PNA) at surgery, cumulative clock hours (CCH) of the ROP lesion, RVOS after IVR, and ROP severity were individually associated with PAR. Multiple logistic regression analysis revealed that RVOS, CCH of the ROP lesion, and PNA at the time of surgery were independent risk factors for PAR. The ROC curve showed that the cutoff value for RVOS was 0.672 DD/month (area under the curve, 0.8184). Conclusions IVR treatment accelerates RVOS; RVOS is inversely related to PAR. RVOS < 0.672 DD/month was a potential predictor of PAR. CCH of the ROP lesion and PNA during surgery were independent risk factors for PAR.