Clinical and laboratory risk factors for relapse (reactivation) of retinopathy of prematurity after intravitreal administration of aflibercept
Authors:   N.I. Pirogov Russian National Research Medical University of the Russian Ministry of Health, Moscow, Russian Federation, Sidorenko E. I. ,   V.F. Voino-Yasenetsky Scientific and Practical Center for Specialized Medical Care in Children of Department of Health of Moscow, Moscow, Russian Federation,   Russian Children’s Clinical Hospital of the N.I. Pirogov Russian National Research Medical University of Russian Ministry of Healt, Moscow, Russian Federation, Sidorenko E. E. ,   N.I. Pirogov Russian National Research Medical University of the Russian Ministry of Health, Moscow, Russian Federation,   V.F. Voino-Yasenetsky Scientific and Practical Center for Specialized Medical Care in Children of Department of Health of Moscow, Moscow, Russian Federation,   Russian Children’s Clinical Hospital of the N.I. Pirogov Russian National Research Medical University of Russian Ministry of Healt, Moscow, Russian Federation, Obrubov S. A. ,   N.I. Pirogov Russian National Research Medical University of the Russian Ministry of Health, Moscow, Russian Federation,   V.F. Voino-Yasenetsky Scientific and Practical Center for Specialized Medical Care in Children of Department of Health of Moscow, Moscow, Russian Federation,   Russian Children’s Clinical Hospital of the N.I. Pirogov Russian National Research Medical University of Russian Ministry of Healt, Moscow, Russian Federation, Hoang Thang L. ,   N.I. Pirogov Russian National Research Medical University of the Russian Ministry of Health, Moscow, Russian Federation,   V.F. Voino-Yasenetsky Scientific and Practical Center for Specialized Medical Care in Children of Department of Health of Moscow, Moscow, Russian Federation,   Russian Children’s Clinical Hospital of the N.I. Pirogov Russian National Research Medical University of Russian Ministry of Healt, Moscow, Russian Federation, Bukhvalova P. A. ,   N.I. Pirogov Russian National Research Medical University of the Russian Ministry of Health, Moscow, Russian Federation,   V.F. Voino-Yasenetsky Scientific and Practical Center for Specialized Medical Care in Children of Department of Health of Moscow, Moscow, Russian Federation,   Russian Children’s Clinical Hospital of the N.I. Pirogov Russian National Research Medical University of Russian Ministry of Healt, Moscow, Russian Federation
Published: April 2024

Purpose. To study the causes of reactivation of retinopathy of prematurity (ROP) after intravitreal aflibercept injections. Material and methods. This study was carried out at V.F. Voino-Yasenetsky Scientific and Practical Center for Specialized Medical Care in Children from September 2021 to February 2023. The study included 101 premature infants (202 eyes) with retinopathy of prematurity who received intravitreal administration of aflibercept. The patients were divided into two groups: the control group included patients who received a single intravitreal injection of a VEGF inhibitor (aflibercept) with a positive effect. The main group included children who received two or more intravitreal injections of VEGF inhibitors (aflibercept) after reactivation of ROP. All patients were monitored for reactivation of retinopathy of prematurity after intravitreal injection of aflibercept. Results. The study noted a statistically significant difference in blood pH levels, stage of ROP, and APROP. In the group with reactivation ROP, APROP was noted 2 times more often (48.94% versus 27.78% in the control group). The group with more intravitreal aflibercept injections had lower blood pH levels (7.348±0.044 versus 7.372±0.030 in the control group). Conclusion. The study showed that clinical and paraclinical risk factors for the development of recurrent (reactivation) of ROP after intravitreal treatment with aflibercept are: severe eye disease (stage of ROP, aggressive posterior ROP), a change in the acid-base balance of the blood towards increased acidity. Blood acidity reflects a generalized process of impaired angiogenesis throughout the body. The more severe the patient’s initial eye condition, the higher the incidence of reactivation of ROP. Key words: recurrence, reactivation, retinopathy of prematurity, risk factor, clinical and paraclinical, aflibercept