Simona Delia Nicoara
Emergency County Hospital, Cluj-Napoca, Romania
Biography:
Simona Delia Nicoara has her expertise in the medical and surgical treatment of retinal diseases. She introduced modern vitreo-retinal surgery in the Department of Ophthalmology belonging to “Iuliu Hatieganu” University of Medicine and Pharmacy, Emergency County Hospital from Cluj-Napoca. She also was the first to perform laser photocoagulation for ROP in the Department and the first anti-VEGF treatment for ROP in Romania. She coordinated 4 national research grants involving vitreo-retinal surgery, vitreo-retinal biomechanics and stem cell regeneration of the retina and optic nerve.
Abstract:
Statement of the Problem: Retinopathy of prematurity (ROP) is a preventable cause of childhood blindness related to premature birth. Most of ROP cases regress spontaneously. Approximately 10% of them are severe and lead to blindness if not treated promptly. The gold standard of care for ROP is laser photocoagulation of the non-vascularized retina. Over the last decade, a new therapeutic option has become available for ROP: intravitreal anti-VEGF injections. The purpose of this study is to describe the experience of our center in treating ROP with laser and/or intravitreal Bevacizumab IVB), with the aim of pointing out the current place of laser photocoagulation in the management of ROP. Methodology & Theoretical Orientation: All the consecutive infants with ROP who received treatment between 2006 - 2017and had at least one year follow up were included in the study. The main outcome measures were the recurrence and the complication rate. Statistical analysis was performed using Microsoft Excel and IBM SPSS software (version 21.0). In the classic form of ROP, the 2 methods showed similar outcomes regarding efficacy. However, in the most severe form of ROP, aggressive posterior ROP (AP-ROP), IVB has led to significantly better outcomes as compared to laser. Additionally, IVB is easier, shorter, nondestructive, requires topical anesthesia, eliminating the risk of general anesthesia in premature infants. Systemic complications related to IVB absorption are still debated, but no report was signaled so far. Within the IVB group, we identified no local complications and within the laser group we report 2 cases of mild anterior uveitis that resolved completely with topical treatment. Conclusion & Significance: IVB has become the first line of treatment in AP-ROP. Laser photocoagulation is the first therapeutic line in the classic form of ROP and in conjunction with IVB in AP-ROP cases that do not regress following IVB.