Reactivation of retinopathy of prematurity after ranibizumab treatment

Retinopathy of prematurity (ROP) is one of the most common causes of visual disability in children born prematurely. Intravitreal injection of angiogenesis inhibitors (antivascular endothelial growth factor [VEGF] therapy) is considered one of the conservative methods of treating ROP. Aim: This study aimed to present a clinical case of ROP reactivation after intravitreal injection of the antiVEGF drug ranibizumab (Lucentis). MATERIAL AND METHODS: The course of retinopathy in a premature infant with extremely low birth weight was studied. RESULTS: A patient diagnosed with ROP, a posterior aggressive form of both eyes, received intravitreal injections of an angiogenesis inhibitor at 36 postconceptional weeks. During subsequent follow-up, disease progression was noted, which necessitated repeated ranibizumab administrations to both eyes. Over time, tractional retinal detachment developed in the right eye, and the disease progressed more slowly in the left eye. At the age of 1 year, ROP rapidly progressed to stage 4B in the left eye. Lens vitrectomy was performed sequentially on the right and then on the left eye. At the age of 1.5 years, the patient had coarse preretinal adhesions in the posterior pole of both eyes and had no spatial vision, whereas light perception was preserved. CONCLUSION: Intravitreal ranibizumab administration for posteriorly aggressive ROP does not exclude its reactivation both early and late after administrations. Further improvement in treatment methods for ROP is necessary.