Table 2 Summary of cases receiving intravitreal anti-VEGF treatment in pregnancy in the literature.
Author, Date | Indication | Intravitreal Anti-VEGF | No. | Gestation at injection | Age (years) | Risk factors for adverse pregnancy outcomes | Obstetric Complications | Pregnancy Outcome | Neonatal/ Child Complications | Known to be pregnant |
|---|---|---|---|---|---|---|---|---|---|---|
2023 | Myopic CNV | Ranibizumab 0.25 mg | 3 | 26, 30, 36 weeks | 39 | Maternal age ≥ 35, BMI > 25 | None | Live birth | NR | Yes |
2023 | DMO | Aflibercept 2 mg | 3 | 2, 15, 21 weeks | 31 | T1DM, ESRD (Dialysis) | IUGR (1005 g) | Live birth | Preterm delivery (29 + 6weeks), reaching developmental milestones | No |
2023 | DMO | Ranibizumab 0.5 mg | 2 | 21 weeks (Bilateral) | 37 | T1DM, ESRD (Dialysis), Maternal age ≥ 35 | PPROM | Stillbirth at 24 weeks (3 weeks after IVI) (PPROM) | N/A | Yes |
2023 | DMO | Ranibizumab 0.5 mg | 2 | 20, 24 weeks | 27 | T1DM, CKD | Pre-eclampsia, IUGR (1005 g) | Live birth | Preterm delivery (29 + 3weeks), initial failure to thrive but no further concerns | Yes |
2023 | DMO | Ranibizumab 0.5 mg | 2 | 34 weeks (Right), 36 (Left) | 32 | T1DM | Pre-eclampsia/ HELLP syndrome | Live birth | No concerns at 22 months | Yes |
2023 | DMO | Aflibercept 2 mg | 2 | 13 weeks (Bilateral) | 37 | T2DM, Maternal age ≥ 35 | Pre-eclampsia, IUGR (1356 g) | Live birth | Preterm delivery (32 + 3 weeks), reaching developmental milestones at 10 months | No |
Akkaya, [30] | DMO | Ranibizumab 0.5 mg | 1 | 5 weeks | 24 | T1DM | Miscarriage | Miscarriage at 6 weeks (6 days after IVI) | N/A | No |
Capuano, [39] | Advanced PDR | Ranibizumab 0.5 mg | 1 | 30 weeks | 33 | T1DM (poor control) | None | Live birth | NR | Yes |
De Groot, [40] | CNV from MFC | Ranibizumab 0.5 mg | 5 | 5, 11, 20, 25, 30 weeks | NR | Multiple previous miscarriages and intrauterine fetal death | Placental abruption | Stillbirth at 33 weeks (Placental abruption) | N/A | Unclear |
De Groot, [40] | CNV from MFC | Ranibizumab 0.5 mg | 2 | 30, 37 weeks | NR | NR | None | Live birth | No neonatal complications | Yes |
De Groot, [40] | CNV from MFC | Ranibizumab 0.25 mg (32 weeks), 0.5 mg (36 weeks) | 2 | 32, 36 weeks | NR | NR | None | Live birth | No neonatal complications | Yes |
De Groot, [40] | CNV from PIC | Ranibizumab 0.5 mg | 2 | 33, 37 weeks | NR | NR | None | Live birth | No neonatal complications | Yes |
De Groot, [40] | CNV from PIC | Ranibizumab 0.5 mg | 1 | 27 weeks | NR | NR | None | Live birth | No neonatal complications | Yes |
De Groot, [40] | CNV from PIC | Bevacizumab 1.25 mg (2 weeks), Ranibizumab 0.5 mg (20 weeks) | 2 | 2, 20 weeks | NR | NR | None. NB: Elective C-section (risk of subretinal haemorrhage from vaginal delivery) | Live birth | No neonatal complications | Unclear |
Fossum, [41] | Idiopathic CNV | Ranibizumab 0.5 mg | 2 | 10, 21 weeks | 26 | Previous miscarriage | None | Live birth | No neonatal complications | Unclear |
,Fossum [41] | Myopic CNV | Ranibizumab 0.5 mg | 1 | 17 weeks | 31 | None | None | Live birth | No neonatal complications | Unclear |
Fossum, [41] | CNV from PIC | Ranibizumab 0.5 mg | 1 | 8 weeks | 30 | ‘Complex obstetric history’ not otherwise specified | Cholestasis of pregnancy at 36 weeks prompting induction at 38 weeks | Live birth | No neonatal complications | Unclear |
,Gomez Ledesma [29] | CNV from POHS | Bevacizumab 1.25 mg | 1 | Within a few days of conception | 41 | Maternal age ≥ 35 | Miscarriage | Miscarriage at 8 weeks (8 weeks after IVI) | N/A | No |
Introini, [42] | Myopic CNV | Bevacizumab 1.25 mg | 1 | 7 weeks | 35 | Maternal age ≥ 35 | None | Live birth | No neonatal complications, reached developmental milestones up to 12 months | Yes, MDT counselling |
Jouve, [43] | Idiopathic CNV | Ranibizumab 0.5 mg | 1 | 8 months | 29 | NR | None | Live birth | No neonatal complications | Yes |
Kianersi, [31] | DMO | Bevacizumab 1.25 mg | 1 | 10 weeks | 29 | T1DM | Miscarriage | Vaginal bleeding 18 h after IVI, subsequent miscarriage ?when | N/A | No |
Kianersi, [32] | Advanced PDR | Bevacizumab 1.25 mg | 1 | 12 weeks | 27 | T1DM (poor control), Previous miscarriages, High BMI | Gestational hypertension, Intrauterine fetal death | Stillbirth at 24 weeks | N/A | No |
Pencak, [44] | Myopic CNV | Ranibizumab 0.5 mg | 1 | 36 weeks | 34 | None | None | Live birth | No neonatal complications | Yes, MDT counselling |
Petrou, [8] | PDR with vitreous hge | Bevacizumab 1.25 mg | 1 | 4 weeks | 29 | T1DM | Miscarriage | Miscarriage at 5 weeks (1 week after IVI) | N/A | No |
Petrou, [8] | Myopic CNV | Bevacizumab 1.25 mg | 1 | 3 weeks | 25 | None | Miscarriage | Miscarriage at 4 weeks (10 days after IVI) | N/A | No |
Polizzi, [33] | DMO, PDR | Bevacizumab 1.25 mg | 2 | Within 5 ± 3 days of ovulation; 4+2 weeks | 37 | Maternal age ≥ 35, T1DM, Hypertension, Previous miscarriage | Elective C-section for suspected macrosomia (not present) | Live birth | Reached developmental milestones up to 24 months | No |
Polizzi, [45] | Myopic CNV | Bevacizumab 1.25 mg | 1 | 13+6 weeks | NR | Maternal age ≥ 35, previous miscarriage | None | Live birth | Reached developmental milestones | Yes |
Polizzi, [45] | CNV from POHS | Bevacizumab 1.25 mg | 2 | 2nd & 3rd trimesters | NR | None | None | Live birth | Reached developmental milestones | Yes |
Polizzi, [45] | CNV from POHS | Bevacizumab 1.25 mg | 2 | 3rd trimester | NR | None | None | Live birth | Reached developmental milestones | Yes |
Rosen, [46] | CNV from PIC | Bevacizumab 1.25 mg | 1 | 3 monthsa | 24 | None | None | Live birth | No neonatal complications up to 3 months | Yes |
Sarhianaki, [47] | Idiopathic CNV | Ranibizumab 0.5 mg | 1 | Start of 3rd trimester | 29 | None | None | Live birth | No neonatal complications | Yes |
Sarmad, [48] | Advanced PDR | Bevacizumab 1.25 mg | 1 | 1 week | 31 | T1DM | None | Live birth | No neonatal complications | Nob |
Sullivan, [34] | Idiopathic CNV | Bevacizumab 1.25 mg | 1 | 19 days | 20 | None | None | Live birth | No complications up to 18 weeks | No |
Sullivan, [34] | CNV from PIC | Bevacizumab 1.25 mg | 1 | 21 days | 27 | None | None | Live birth | No complications up to 6 weeks | Noc |
Sullivan, [34] | PDR | Bevacizumab 1.25 mg | 1 | 24 days | 20 | DM | None | Live birth | No complications up to 11 months | No |
Sullivan, [34] | PDR with NVG | Bevacizumab 1.25 mg | 1 | 20 days | 25 | DM, Hypertension | C-section for pre-eclampsia, IUGR (1260 g) | Live birth | Pre-term delivery (29 weeks); intubated for respiratory distress and pulmonary hge; ICH; blood transfusion for abnormal clotting and anaemia of prematurity | No |
Tarantola, [9] | CNV from sarcoid uveitis | Bevacizumab 1.25 mg | 4 | 17, 21, 26, 31 weeks | 31 | NR | None | Live birth | No neonatal complications, reached developmental milestones up to 8 months | Yes |
Tarantola, [9] | CNV from POHS | Bevacizumab 1.25 mg | 6 | 1, 9, 14, 20, 26, 32 weeks | 36 | Maternal age ≥ 35 | Macrosomia | Live birth | No neonatal complications, normal growth and development | No |
Tarantola, [9] | CNV from PIC | Bevacizumab 1.25 mg | 1 | 3 weeks | 33 | NR | None | Live birth | No neonatal complications, normal growth and development up to 12 months | Unknown |
Tarantola, [9]d | CNV from POHS | Bevacizumab 1.25 mg | 1 | 23 weeks | 27 | NR | None | Live birth | No neonatal complications, normal growth and development up to 23 months | Yes |
CNV from POHS | Bevacizumab 1.25 mg | 1 | 36 weeks | 28 | NR | None | Live birth | No neonatal complications, normal growth and development up to 9 months | Yes | |
Wu, [35] | Myopic CNV | Bevacizumab 1.25 mg | 1 | 2 weeks | 25 | None | None | Live birth | No complications up to 12 months | No |
