Premature babies are to be routinely offered a “life-changing” treatment to prevent blindness on the NHS for the first time, the head of the health service has announced today.
The drug, ranibizumab, could save the eyesight of babies born with a condition known as retinopathy of prematurity (ROP), which affects blood vessels in the retina, creating damaging scar tissue and causing blindness.
Currently, laser treatment is the standard of care – however, some premature babies are too unwell and fragile to receive laser treatment, which also carries a risk of leaving scarring on the retina and permanently damaging vision.
The new routine option – announced by NHS chief executive Amanda Pritchard ahead of the 75th anniversary of the health service tomorrow (Wed 5 July) – is to be made available across England as an alternative to laser treatment for some forms of ROP, following the publication of new national NHS guidance.
The drug is administered into the eye using a precise injection system that does not cause any scarring, which is particularly important in babies with ROP in the central, most sensitive part of their vision.
Ranibizumab is an off-patent drug already routinely used in adults with wet age-related macular degeneration, that has been found to be effective compared with laser treatment in children. The drug temporarily stops the action of a growth protein called Vascular Endothelial Growth Factor (VEGF), which reduces or reverses the growth of the abnormal blood vessels.
As ROP is preventable, all preterm or low birth weight babies are screened for it on the NHS. If severe ROP is diagnosed, treatment with ranibizumab could begin within two or three days. Up to one in three (31%) of babies will need a second treatment within four months of the first treatment taking place, and they will have regular follow up in the first six months followed by annual follow up to age five.
Millie Swan, from Surrey, was born prematurely at 23 weeks. She spent five months at St Peter’s Hospital under close monitoring to deal with various medical issues, including regular monitoring of her eyes.
Due to the extra oxygen she was given to support her lungs, she developed retinopathy of prematurity, and when she was three months old the condition became so severe in her left eye that she needed urgent treatment to save her sight.
Millie’s mum Natalie said: “She was meant to have laser treatment, which is the usual way to treat this condition, but when they gave her the sedative to prepare her for the procedure she didn’t tolerate it at all, so they couldn’t start the procedure.
“At this point we thought she would end up blind in her left eye, but we were lucky enough to get offered this new treatment, which was an injection into the eye.
“I stayed with her for the procedure. Millie needed to have her eye clamped open but I was used to seeing that happen for her assessments. And the treatment was finished in a couple of minutes. That was much quicker than the laser surgery would have been. After the procedure, Millie spent a couple of days recovering.
“Millie will be three years old in July and her eyesight is now normal and she enjoys looking at the pictures in her books and aeroplanes in the sky.”
She goes back to the hospital for a check-up once a year and at the last appointment, clinicians told the family Millie doesn’t need glasses currently.
Natalie said: “We feel so lucky that she got to have this procedure and avoided almost certain blindness in that eye, and now other families will be able to benefit from it too.”
Announcing the national roll-out of the treatment ahead of the NHS’s 75th anniversary tomorrow, NHS chief executive Amanda Pritchard said: “The impacts of vision loss can be absolutely devastating, particularly for children and young people, so it’s fantastic that this treatment will now give families across the country another life-changing option to help save their child’s precious sight.
“The national roll-out of this lifeline treatment for babies who are too poorly to undergo laser therapy is a vital step forward in preventing avoidable vision loss, and as we prepare to mark our 75th anniversary this is another example of how the NHS continues to ensure that the latest and most effective treatments are available for everyone who needs them.”
Health Minister Neil O’Brien said: “No baby should have to suffer avoidable sight loss, and parents should be confident that conditions like this in their children can be both detected and prevented at the earliest opportunity.
“That’s why this potentially life-changing treatment is being rolled out – to improve the futures and outcomes of babies and their families nationwide.
“We are committed to eliminating avoidable blindness and have appointed a National Clinical Director for eye care who will help us make sure patients receive the care they need, and we continue to invest in and train our ophthalmology workforce.”