ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR THERAPY FOR STAGES 3 AND 4 PROLIFERATIVE SICKLE CELL RETINOPATHY RESULTS IN IMPROVED ANATOMICAL AND VISUAL OUTCOMES.

Abstract

To investigate the potential utility of intravitreal antivascular endothelial growth factor (anti-VEGF) therapy for stages 3 and 4 proliferative sickle cell retinopathy (PSR). Retrospective review of anatomical and visual acuity outcomes after intravitreal anti-VEGF therapy for stages 3 and 4 PSR eyes. There were 45 PSR eyes (17 stage 3 and 28 stage 4) treated with anti-VEGF agents (bevacizumab (37 eyes), aflibercept (6 eyes), ranibizumab (3 eyes), one eye received both bevacizumab and aflibercept). Follow-up ranged from 1 to 120 months (mean = 21 months). Within 1 month after anti-VEGF treatment, VA improved ≥2 lines in 18/45 eyes, remained stable in 26/45 eyes, and worsened in 1/45 eyes. The median visual acuity remained 20/20 for stage 3 and improved from 20/200 to 20/30 for stage 4 PSR eyes. More stage 4 PSR eyes had VA improvement posttreatment than stage 3 PSR eyes ( P = 0.003). There were no cases of endophthalmitis. Visual acuity outcomes were similar for anti-VEGF with and without laser treatment. Control of PSR was achieved in 42/45 (93%) of eyes without the need for pars plana vitrectomy. Within one month of treatment, administration of anti-VEGF therapy of PSR eyes resulted in seafan regression, clearing of vitreous hemorrhage, and stable or improved vision in most eyes.