Table 1 Clinical summary of patients who received intravitreal anti-VEGF treatment in pregnancy in our case series.

From: Intravitreal anti-vascular endothelial growth factor injections in pregnancy and breastfeeding: a case series and systematic review of the literature

ID

Indication

Age (years)

Intravitreal Anti-VEGF given

Eye

No.

Gestation (weeks) at injection

Risk factors for miscarriage

Obstetric Complications

Pregnancy Outcome

Neonatal/ Child Complications

Counselling

Baseline VA

VA 4 weeks after IVI

Last known VA

Follow-up (month)

Ocular Comorbidities

1

Myopic CNV

39

Ranibizumab 0.25 mg

Right

3

26, 30, 36

Maternal age ≥ 35, BMI > 25

None

Live birth

Unknown

Medical retina consultant

0.74

0.40

0.70

77

Myopic macular degeneration, Scleral buckle for RRD

2

DMO

31

Aflibercept 2 mg

Right

3

2, 15, 21

T1DM, ESRD (Dialysis)

IUGR (1005 g)

Live birth

Preterm delivery (29 + 6 weeks), reached developmental milestones as of 4 years

Not known to be pregnant at time of injection; later counselled by vitreoretinal team

0.50

0.60

0.48

58

PPV/Delam/SO for TRD

3

DMO

37

Ranibizumab 0.5 mg

Both

2

21 (Bilat)

T1DM, ESRD (Dialysis), Maternal age ≥ 35,

PPROM

Stillbirth 3 weeks after IVI (PPROM)

N/A

Medical retina + Obstetric medicine consultants

0.30 R, 0.30 L

0.40 R, 0.30 L

0.40 R, 0.30 L

39

NPDR

4

DMO

27

Ranibizumab 0.5 mg

Right

2

20, 24

T1DM, CKD

Pre-eclampsia, IUGR (1005 g)

Live birth

Preterm delivery (29 + 3 weeks), initial failure to thrive but no further concerns at 22 months

Obstetric medicine consultant

1.08

1.18

2.70

24

Concurrent high-risk PDR treated with PRP during pregnancy

5

DMO

32

Ranibizumab 0.5 mg

Both

2

34 (Right), 36 (Left)

T1DM

Pre-eclampsia/ HELLP syndrome

Live birth

No concerns at 22 months

Obstetric Medicine consultant

0.40 R, 0.40 L

0.30 R, 0.40 L

0.20 R, 0.00 L

22

PDR

6

DMO

37

Aflibercept 2 mg

Both

2

13 (Bilat)

T2DM, Maternal age ≥ 35

Pre-eclampsia, IUGR (1356 g)

Live birth

Preterm delivery (32 + 3 weeks), reached developmental milestones as of 10 months

Not known to be pregnant at time of injection; no further injections given

0.48 R, 0.78 L

NR

0.30 R, 0.30 L

15

NTG, RE trabeculectomy & complicated cataract surgery

  1. CNV choroidal neovascularisation, DMO diabetic macular oedema, VEGF anti-vascular endothelial growth factor, BMI body mass index, ESRD end stage renal disease, CKD chronic kidney disease, IUGR intrauterine growth restriction, PPROM preterm premature rupture of membranes, HELLP haemolysis elevated liver enzymes low platelets, IVI intravitreal injection, VA visual acuity, RRD rhegmatogenous retinal detachment, TRD tractional retinal detachment, NPDR non-proliferative diabetic retinopathy, PDR proliferative diabetic retinopathy, NTG normal tension glaucoma.
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