Supplemental Table 1.

The survey questionnaire

Anti-vegf in retinopathy of prematurity (ROP) survey (Indian rop society)
Age (Years)
Gender:
Male
Female
Prefer Not To Say
Other ____
Where do you practice:
Own Clinic
Government Institute
Private Institute
Charitable Institute
Other ____
Approximate years of experience in Ophthalmology
Which sub speciality do you practice:
Vitreo Retina
Medical Retina
Pediatric Ophthalmology
Comprehensive/General Ophthalmology
Other ____
Approximate years of experience in sub speciality
Professional memberships:
Vitreoretinal Society Of India (VRSI)
Indian ROP (iROP) Society
Strabismus And Pediatric Ophthalmological Society Of India (SPOSI)
All India Ophthalmological Society Of India (AIOS)
Approximate years of experience in ROP screening and treatment
Approximate number of infants screened per month (fresh and follow up)
Approximate number of infants treated per month
Do you use anti-VEGF injection in treating ROP
Yes
No
Approximate no. of infants treated with anti-VEGF per month:
1
2
3
4
5
6
7
8
9
10
>10
Other ____
In which of the following situation you are most likely to use anti-VEGF:
Type 1 ETROP (staged ROP with plus disease)
APROP/Hybrid ROP
When laser cannot be done (non-dilating pupil, dense tunica vasculosa lentis, vitreous haze)
Persistent or recurrent plus disease
Not applicable
Other____
Which anti-VEGF do you most often use in ROP? (Considering Safety, Efficacy, Medico Legal Issue, Cost):
Bevacizumab
Ranibizumab
Aflibercept
Bio similar (Razumab)
Other____
Did injecting anti-VEGF for ROP in your practice under go any change after the DGCI ban on Avastin (ban was lifted for adults)
Yes, I have stopped using anti-VEGF altogether for ROP
Yes, I have stopped using Avastin and started using Ranibizumab for ROP
Yes, I am still using avastin but taking a written informed consent where details about off label use, lack of safety profile in preterm and possible effect on neuro development are mentioned
No, I am still using avastin with general consent for intravitreal injection
Not applicable
Other___
What dose of anti-VEGF do you use in ROP?
Similar to an adult dose
Half of an adult dose
One-fourth of an adult dose
Less than one-fourth of an adult dose
Not applicable
Other____
What type of anaesthesia do you use during intravitreal injection in infants?
Topical
General
Sedation
Not applicable
Other____
Where do you perform the injection procedure?
Out patient
Minor OR
Main OR
NICU
Any of the above depending up on the systemic status of the neonate
Not applicable
At what distance from limbus do you inject anti-VEGF in preterm infants?
1MM
1.5MM
2MM
Not applicable
Which quadrant do you prefer for injecting anti-VEGF in preterm infants?
Supero nasal
Supero temporal
Infero nasal
Infero temporal
Any of the above depending upon infants bells reflex
Not applicable
Other____
What is your treatment protocol?
One eye at a time
Both eyes together
Not applicable
Other____
When do you inject in other eye? (if you are injecting in one at a time)
How do you obtain and prepare your anti-VEGF injection for ROP?
Pre filled syringes and stored in refrigerator
Lab made aliquots and stored in refrigerator
Direct from vial (single use)
Direct from vial (multiple use)
Not applicable
Other____
What is your follow up protocol/schedule after injection of anti-VEGF?
Twice a week
Weekly
Fortnightly
Guided by the disease severity prior to injection
Not applicable
Other____
What type of consent do you take before using anti-VEGF in ROP?
I am taking a specially drafted/written consent before using anti-VEGF in ROP
AIOS and VRSI consent for Avastin
A general consent for anti-VEGF injection/surgery
I am not taking consent before using anti-VEGF in ROP
Not applicable
Does your consent form have points that the drug is ‘off label, not validated for safety and can cause potential unknown and known side effects including neuro developmental delay and abnormalities?
Yes
No
Sometimes or partly
Not applicable
Do you photo document your cases before and after giving injection anti-VEGF?
Yes
No
Sometimes or partly
Not applicable
Do you perform fundus angiography any timeprior, or after injection anti-VEGF
Yes
No
Sometimes or partly
Not applicable
Do you perform any additional systemic monitoring for eyes that receive anti-VEGF medication (over and above laser treated eyes)?
Yes
No
On discretion of neonatologist
Not applicable
Are you aware that VRSI has provided guidelines for use of anti-VEGF in adults (after the ban was lifted) but does not mention the use of the drug in infants or ROP?
Yes
No
Do you feel the need for a recommendation on the use of anti-VEGF for treatment of ROP in INDIA?
Yes
No
Are the results of this survey likely to alter your pattern of anti-VEGF use in ROP?
Yes
No
Cannot say at present