Dr.Nilutpal Borah, B07914
To study effect of intravitreal Avastin(IVB),Lucentis(IVL)with photocoagulation(phc)in premature,very low birth weight(LBW)babies with APROP.
16 eyes(8 babies)studied(May,2015-April,2018).Included:premature (26-28wk) LBW(700-1200gm)babies,APROP +/- vitreous hem(VH). Treatment age 32-34wks.Parents had chosen IVB or IVL after explanation. IVB/IVL(0.1ml)were injected in OT under anesthesia & Phc(532nm)given after 1wk.Eye with advanced APROP was injected first.
Total eyes-IVB(8),IVL(8),Phc(16).Mean FU-16 mo.After IVB/IVL+phc-at I wk iris,lens NV(16) & at 1 mo retinal NVE regressed(14).Repeat phc-2 eyes.At 8 wks VH(n=3) absorbed.Complications:bilateral RD(1baby),vision in 1eye after operation(follows light).Lens injury(n=1).Apnoea,bradycardia(n=3).
Conclusion:In our study IVB/IVL was safe,effective in APROP.IVB/IVL+phc could salvage posterior retina(zone I)in 88% eyes.Off label Avastin use needs caution.Neonatologist should be present in case of emergency.
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