Subscribe to RSS
DOI: 10.1055/s-0029-1245717
© Georg Thieme Verlag KG Stuttgart · New York
VEGF-Antikörper in der Therapie der Frühgeborenenretinopathie
VEGF Antibodies as Therapy for Retinopathy of PrematurityPublication History
Eingegangen: 31.5.2010
Angenommen: 24.8.2010
Publication Date:
15 September 2010 (online)

Zusammenfassung
Die Frühgeborenenretinopathie zählt zu den 3 häufigsten Erblindungsursachen der Kindheit in Industrienationen. Immer weiter verbesserte Möglichkeiten der neonatologischen Versorgung haben zu einer erhöhten Überlebenswahrscheinlichkeit immer unreiferer Kinder geführt, die wiederum ein erhöhtes Risiko haben, eine Frühgeborenenretinopathie zu entwickeln. Die bisher etablierte Laserkoagulation in der Therapie der Frühgeborenenretinopathie führt bei einem zeitgerechten Einsatz zu einer guten Rückbildung der pathologischen Gefäßneubildungen und kann dadurch die Entwicklung einer Netzhautablösung verhindern. Die Koagulation der avaskulären Netzhautareale führt jedoch zu einer Vernarbung dieser Netzhautbereiche und unterstützt die weitere Netzhautentwicklung nicht. Seit jüngster Zeit gibt es erste vielversprechende Berichte über den intravitrealen Einsatz von VEGF-Antikörpern bei der Frühgeborenenretinopathie. Die vorliegende Arbeit berichtet über eigene Erfahrungen mit dieser Therapie und möchte einen Überblick über den derzeitigen Stand der Literatur zu diesem Thema geben.
Abstract
Retinopathy of prematurity (ROP) is one of the three leading causes of legal blindness in childhood in the developed countries. Improved neonatal care has resulted in the increased survival of extremely immature infants at high risk to develop ROP. Current treatment for ROP with laser may prevent blindness by causing involution of pathological vessels and thus inhibit the development of retinal detachment. But this coagulation of the avascular retina is a destructive therapy and does not otherwise ameliorate retinal development. Recent reports have described vascular endothelial growth factor antibodies as therapy for ROP. This article reports our own experience with this new therapy and gives an overview of the recent literature.
Schlüsselwörter
Frühgeborenenretinopathie - Anti-VEGF - Bevacizumab - vascular endothelial growth factor
Key words
retinopathy of prematurity - anti-VEGF - bevacizumab - vascular endothelial growth factor
Literatur
- 1
An International Committee for the Classification of Retinopathy of Prematurity .
The International Classification of Retinopathy of Prematurity revisited.
Arch Ophthalmol.
2005;
123
991-999
MissingFormLabel
- 2
Arevalo J F, Maia M, Flynn H W et al.
Tractional retinal detzachment following intravitreal bevacizumab (Avastin) in patients
with severe proliferative diabetic retinopathy.
Br J Ophthalmol.
2008;
92
213-216
MissingFormLabel
- 3
Axer-Siegel Jr R, Maharshak I, Snir M et al.
Diode laser treatment of retinopathy of prematurity: anatomical and refractive outcomes.
Retina.
2008;
28
839-846
MissingFormLabel
- 4
Brennan R, Gnanaraj L, Cottrell D G.
Retinopathy of prematurity in practice. I: screening for threshold disease.
Eye.
2003;
17
183-188
MissingFormLabel
- 5
Capone Jr A, Diaz-Rohena R, Sternberg Jr P et al.
Diode-laser photocoagulation for zone 1 threshold retinopathy of prematurity.
Am J Ophthalmol.
1993;
116
444-450
MissingFormLabel
- 6
Chung E, Kim J, Ahn H et al.
Combination of laser photocoagulation and intravitreal bevacizumab (Avastin) for aggressive
zone I retinopathy of prematurity.
Graefes Arch Clin Exp Ophthalmology.
2007;
245
1727-1730
MissingFormLabel
- 7
Connolly B P, Ng E Y, McNamara J A et al.
A comparison of laser photocoagulation with cryotherapy for threshold retinopathy
of prematurity at 10 years: part 2. Refractive outcome.
Ophthalmology.
2002;
109
936-941
MissingFormLabel
- 8
Cryotherapy for Retinopathy of Prematurity Cooperative Group .
Multicenter trial of cryotherapy for retinopathy of prematurity. Preliminiary results.
Arch Ophthalmol.
1988;
106
471-479
MissingFormLabel
- 9
Cryotherapy for Retinopathy of Prematurity Cooperative Group .
Multicenter trial of cryotherapy for retinopathy of prematurity. Final results. 15-year
outcomes following threshold retinopathy.
Arch Ophthalmol.
2005;
123
311-318
MissingFormLabel
- 10
Cunningham S, Fleck B W, Elton R A et al.
Transcutanous oxygen levels in retinopathy of prematurity.
Lancet.
1995;
346
1464-1465
MissingFormLabel
- 11
Field D, Dorling J, Manktelow B et al.
Survival of extreme premature babies in a geographically defined population: prospective
cohort study of 1994 – 9 compared with 2000 – 5.
BMJ.
2008;
336
1221-1223
MissingFormLabel
- 12
Fleck B W, McIntosh N.
Pathogenesis of retinopathy of prematurity and possible preventive strategies.
Early Human Development.
2008;
84
83-88
MissingFormLabel
- 13
Giannantonio C, Papacci P, Molle F et al.
An epidemiological analysis of retinopathy of prematurity over ten years.
J Pediatr Ophthalmol Strabismus.
2008;
45
162-167
MissingFormLabel
- 14
Hellström A, Ley D, Hansen-Pupp I et al.
New insights into the development of retinopathy of prematurity – importance of early
weight gain.
Acta Paediatrica.
2010;
99
502-508
MissingFormLabel
- 15
Holmstrom G, el Azazi M, Kugelberg U.
Ophthalmological follow up of preterm infants: a population based, prospective study
of visual acuity and strabismus.
Br J Ophthalmol.
1999;
83
143-150
MissingFormLabel
- 16
Honda S, Hirabayashi H, Tsukahara Y et al.
Acute contraction of the proliferative membrane after an intravitreal injection of
bevacizumab for advanced retinopathy of prematurity.
Graefes Arch Clin Exp Ophthalmol.
2008;
246
1061-1063
MissingFormLabel
- 17
Hughes S, Yang H, Chan-Ling T.
Vascularization of the human fetal retina: roles of vasculogenesis and angiogenesis.
Invest Ophthalmol Vis Sci.
2000;
41
1217-1228
MissingFormLabel
- 18
Jandeck C, Kellner U, Heimann H et al.
Koagulatioinstherapie der Frühgeborenenretinopathie: Vergleich der anatomischen und
funktionellen Ergebnisse nach Laser- oder Kryokoagulation.
Ophthalmologe.
2005;
102
33-38
MissingFormLabel
- 19
Jandeck C, Kellner U, Heimann H et al.
Frühgeborenenretinopathie-Screening: Ergebnisse eines Zentrums zwischen 1991 und 2002.
Klin Monatsbl Augenheilkd.
2005;
222
577-585
MissingFormLabel
- 20
Jandeck C, Kellner U, Lorenz B et al.
Arbeitsgruppe der Retinologischen Gesellschaft zur Erstellung der Leitlinie zur augenärztlichen
Screening-Untersuchung von Frühgeborenen. Augenärztliche Screening-Untersuchung von
Frühgeborenen.
Klin Monatsbl Augenheilkd.
2008;
225
123-130
MissingFormLabel
- 21
Jandeck C.
Neue therapeutische Ansätze in der Behandlung Frühgeborenenretinopathie.
Klin Monatsbl Augenheilkd.
2009;
226
914-920
MissingFormLabel
- 22
Kusaka S, Shima C, Wada K et al.
Efficacy of intravitreal injection of bevacizumab for severe retinopathy of prematurity:
a pilot study.
Br J Ophthalmol.
2008;
92
1450-1455
MissingFormLabel
- 23
Lad E, Nguyen T, Morton J et al.
Retinopathy of prematurity in the United States.
Br J Ophthalmol.
2008;
92
320-325
MissingFormLabel
- 24
Law J C, Recchia F M, Morrison D G et al.
Intravitreal bevacizumab as adjunctive treatment for retinopathy of prematurity.
J AAPOS.
2010;
14
6-10
MissingFormLabel
- 25
Lalwani G, Berrocal A, Murray T et al.
Off-Label use of intravitreal bevacizumab (Avastin) for salvage treatment in progressive
threshold retinopathy of prematurity.
Retina.
2008;
28
13-18
MissingFormLabel
- 26
Larsson E, Carle-Petrelius B, Cernerud G et al.
Incidence of ROP in two consecutive Swedish Population based studies.
Br J Ophthalmol.
2002;
86
1122-1126
MissingFormLabel
- 27
Löfqvist C, Anderson E, Sigurdsson J et al.
Longitudinal postnatal weight and Insulin-like Growth Factor I measurements in prediction
Retinopathy of Prematurity.
Arch Ophthalmol.
2006;
124
1711-1718
MissingFormLabel
- 28
Mc Colm J R, Cunningham S, Wade J et al.
Hypoxic oxygen fluctuations produce less severe retinopathy of prematurity.
Pediatr Res.
2004;
55
107-113
MissingFormLabel
- 29
Mintz-Hittner H, Kuffel R.
intravitreal injection of bevacizumab (Avastin) for treatment of stage 3 retinopathy
of prematurity in zone I or posterior zone II.
Retina.
2008;
28
831-838
MissingFormLabel
- 30 Mintz-Hittner H. BEAT-ROP study (bevacizumab eliminates the angiogenic threat of ROP: Clinical trials.gov
Identifier: NCT 0 062 726). 2009 (Stand: Phase II recruiting). http://www.Clinicaltrials.gov
MissingFormLabel
- 31
Mintz-Hittner H A, Best L M.
Antivascular endothelial growth factor for retinopathy of prematurity.
Curr Opin Pediatr.
2009;
21
182-187
MissingFormLabel
- 32
Mintz-Hittner H A.
Avastin as monotherapy for retinopathy of prematurity.
J AAPOS.
2010;
14
2-3
MissingFormLabel
- 33
Nazari H, Modarres M, Parvaresh M M et al.
Intravitreal bevacizumab in combination with laser therapy for the treatment of severe
retinopathy of prematurity (ROP) associated with vitreous or retinal hemorrhage.
Graefes Arch Clin Exp Ophthalmol.
2010;
; Epub ahead
MissingFormLabel
- 34
Ng E Y, Connolly B P, McNamara J A et al.
A comparison of laser photocoagulation with cryotherapy for threshold retinopathy
of prematurity at 10 years: part 1. Visual function and structural outcome.
Ophthalmology.
2002;
109
928-934, discussion 35
MissingFormLabel
- 35
Paysse E A, Lindsey J L et al.
Therapeutic outcomes of cryotherapy versus transpupillary diode laser photocoagulation
for threshold retinopathy of prematurity.
J AAPOS.
1999;
3
234-240
MissingFormLabel
- 36
Reynolds J D, Dobson V, Quinn G E et al.
Evidence-based screening criteria for retinopathy of prematurity: natural history
data from the CRYO-ROP and LIGHT-ROP studies.
Arch Ophthalmol.
2002;
120
1470-1476
MissingFormLabel
- 37
Smith L E, Shen W, Perruzzi C et al.
Regulation of vascular endothelial growth factor-dependent retinal neovascularisation
by insulin-like growth factor-1 receptor.
Nat Med.
1999;
5
1390-1395
MissingFormLabel
- 38
Smith L E.
Through the eyes of a child: understanding retinopathy through ROP – the Friedenwald
lecture.
Invest Ophthalmol Vis Sci.
2008;
49
5177-5182
MissingFormLabel
- 39
Sonmez K, Drenser K, Capone A et al.
Vitreous levels of stromal cell-derived factor 1 and vascular endothelial growth factor
in patients with retinopathy of prematurity.
Ophthalmology.
2008;
115
1065-1070
MissingFormLabel
- 40
The Laser ROP Study Group .
Laser therapy for retinopathy of prematurity.
Arch Ophthalmol.
1994;
12
154-156
MissingFormLabel
- 41
Travassos A, Teixeira S, Ferreira P et al.
Intravitreal bevacizumab in aggressive posterior retinopathy of prematurity.
Ophthalmic Surg Lasers imaging.
2007;
38
233-237
MissingFormLabel
- 42 Trese M. BLOCK-ROP study. 2009 Identifier: NCT00702819 (Stand: Phase II Recruiting). http://www.ClinicalTrials.gov
MissingFormLabel
- 43
White J E, Repka M X.
Randomized comparison of diode laser photocoagulation verus cryotherapy for threshold
retinopathy of prematurity: 3-year outcome.
J Pediatr Ophthalmol Strabismus.
1997;
34
83-87
MissingFormLabel
Priv. Doz. Dr. Isabel Maria Oberacher-Velten
Klinik und Poliklinik für Augenheilkunde, Klinikum der Universität Regensburg
Franz-Josef-Strauß-Allee
93053 Regensburg
Phone: ++ 49/9 41/9 44 92 29
Fax: ++ 49/9 41/9 44 92 16
Email: isabel.velten@klinik.uni-regensburg.de