DR. PUJA MAITRA

DR. PARAG K. SHAH, DR. PREMA K.V. SUBRAMANIAM, DR. ABHISHEK DAS

Abstract

An emerging concern with using intravitreal anti VEGF in ROP is development or worsening of traction (Crunch phenomenon). Due to shorter t½, Ranibizumab(RZB) is expected to cause lesser incidence/less severe traction . Between October 2021 and June2022, 10 eyes with more than 6 clock hours of Stage 4 ROP were injected with RZB 0.02 ml with the intent of surgical intervention within a week. Mean post conceptional age(PCA) at the time of injection was 40 weeks(range 38-44 weeks). No worsening of traction was noted in any eyes. 3 eyes showed resolution of exudation. Extensive pre-existing fibrosis and higher PCA are risk factors for developing Crunch phenomenon post Anti VEGF injection– especially bevacizumab. We did not note Crunch phenomenon in our Ranibizumab treated patients probably due to shorter t½ causing faster concentration fall below effective concentration and can be considered with lesser risk in ROP eyes with traction and higher PCA