Efficacy and Safety of Low Dose Intravitreal Ranibizumab for Treatment of Retinopathy of Prematurity

Abstract Background: Retinopathy of prematurityis a real public health problem in low and middle-income countries like Egypt. With the improvement of neonatal care and the increased survival of low-birth-weight babies, there is a real increase in the risk of vision loss from this disease, and a better understanding of the best treatment options will help to control the disease and save the sight of these babies. Aim of Study: To evaluate safety, efficacy, and recurrence rate of lowdose intravitreal ranibizumab therapy in the treat-ment of type 1 retinopathy of prematurity. Patients and Methods: Between January 2019 and De-cember 2020, this retrospective comparative case series study was conducted on 100 eyes from fifty individuals who received intravitreal ranibizumab injections after being diagnosed with type 1 retinopathy of prematurity (ROP) and aggressive ROP. The included infants were divided into 2 groups, the first group (50 eyes) received the conventional dose (0.25mg) and the second group (50 eyes received low-dose intravitreal ranibizumab (0.12mg).). Results: A total of one hundred eyes of fifty infants (25 in each group) were included in the study, with a mean gestational age of 31.7±1.3 weeks and a mean birth weight of 1544.2±323.9g. No intraoperative or postoperative compli-cations were observed in either group. There was no significant difference in efficacy between the two groups in terms of post-injection complete vascularization and the absence of pathological vascular hyperplasia or retinal proliferation in the non-complete vascular retina. Concerning the post-injection recurrence rate, 2 infants in each group had a recurrence, which was treated with a second injection of the same dose of ranibizumab. Conclusion: Intravitreal injection of low dose ranibizumab is an effective and safe method for the treatment of type 1 ROP and aggressive ROP.