Fluorescein Angiography Evaluation of Children Previously Treated with Anti-VEGF Monotherapy for Retinopathy of Prematurity

Abstract

Purpose: To determine the level of vascularization and peripheral vascular findings by fluorescence angiography (FA) in patients with aggressive retinopathy of prematurity (A-ROP) or type 1 retinopathy of prematurity (ROP) treated with a single dose of anti-vascular endothelial growth factor (VEGF). Methods: Data of patients referred to our clinic for FA examination between June 2016 and September 2021 were retrospectively analyzed. Patients who had their first FA examination at the age of 1 year or older were included in the study. Results: A total of 486 eyes of 250 patients were included. Of these, 83 eyes (17.1%) had vascular termination in zone II and 403 eyes (82.9%) in zone III. In 62.7% of eyes, the distance from the vascular terminals to the temporal ora serrata was less than 2 disc diameters (DD) and in 20.2% it was more than 2 DD. Abnormal vascular findings were noted, including circumferential vessels (41.2%), finger-like projection anomaly (36.2%), hyperfluorescence (16.9%), fine branching and blunt termination (15%), and arteriovenous shunt (9.9%). Conclusion: FA performed late in the course of treatment can clearly define the vascular termini and detect abnormalities that cannot be detected by indirect ophthalmoscopy. Follow-up with FA can help prevent complications that can lead to vision loss.