Treatment for non-type 1 retinopathy of prematurity by intravitreal injection of anti-vascular endothelial growth factor drugs

Abstract Background: To explore clinical characteristics and treatment reasonsfor intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF) drugs in the treatment of non-type 1 retinopathy of prematurity (ROP). Methods: A retrospective study was conducted to screen the non-type 1 ROP from the collected ROP patients who received intravitreal injection of anti-VEGF drugs in Henan Eye Hospital from September 2018 to June 2021. Results: A total of 138 ROP cases (262 eyes) were included in this study, including 39 cases (28.3%) 65 eyes (24.8%) were the non-type 1 ROP. Compared with the type 1 ROP group, the non-type 1 ROP group had slightly later treatment time (39.8±2.7 weeks vs 38.1±2.6 weeks, P<0.05) and a higher proportion of fusion protein drugs (87.2% vs 54.5%, P<0.05). After intravitreal injection of anti-VEGF drugs, 27 eyes (41.5%) were cured and 38 eyes (58.5%) were improved in the non-type 1 ROP group, without recurrence and aggravation cases. There were more lesions in zone II (63 eyes, 96.9%), with stage 2 (40 eyes, 61.5%) and stage 3 (23 eyes, 35.4%), and 58 eyes (89.2%) showed pre-plus in the non-type 1 ROP group. Treatment reasons included pre-plus in 58 eyes (89.2%), ridge aggravation in 22 eyes (33.8%), simultaneous treatment of the contralateral eye in 9 eyes (13.8%), no regression of lesions in persistent stage 2 or 3 over PMA 44 weeks of follow-up in 8 eyes (12.3%), and logistical considerations in 4 eyes (6.2%). Conclusions: Considering some peculiar clinical characteristic, treatment by intravitreal injection of anti-VEGF drugs may be considered carefully for some non-type 1 ROP in critical conditions.