Session Title: FP-14 Vascular Diseases and Diabetic Retinopathy IV
Session Date/Time: Saturday 13/09/2014 | 16:30-18:00
Paper Time: 17:42
Venue: Boulevard F
First Author: : A.Oros SERBIA
Co Author(s): : B. Dedovic Z. Grgic M. Kostic
The hallmark ROP activity is plus sign. VEGF expresses the activity in multiplications of vascular endothelial cells, loss of apoptosis and breaking of the intercellular protein connections. That results with multiplications of vascular networks without the nourishing potential for developing retina. The use antiVEGF therapy is resulting in braking of ROP activity. In contrast to laser teratment, the development of retina and its vascular vessels is continued.
The pathogenesis of AP-ROP involves a complex of relationships among avasculare retina, immature vessels, oxygen levels, and signals transduction. Molecular messengers geneated in hypoxic retina induce growth of vessels and proliferation.
The application of anti-VEGF agent in mono dose regime has been performed in 37 patients with severe form of AP-ROP. The localization of ischemic processes was in large areas of retina. This is part of prospective, controlled and RetCam documented study of ROP treatment with anti-VEGF agent. RetCam and/or FA have been used to evaluate the anatomic outcome. In cases of reactivation of pathologic proliferation, second dose of antiVEGF has applicated.
Using the one dose of bevacizuamb, the vascularization has reached the periphery in all cases, except in five babies from 37. In both eyes of five babies have occurred new wave of proliferation. The ridge was formated on the ends of temporal arcades. Fluorescein angiography has showed spacious avascular zone of temporal retina connected with fovea. Retreatment with antiVEGF agent has resulted in regression of activity, giving the conditions for development of vascular network to the periphery.
The results depend on morphology of the lesion and vascular-avascular retina ratio. Those conditions make the difficulty for macula development. Using the images methods we have a way of interpreting the results of antiVEGF and overview of the relation between retina and its vascularization during development .