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Intravitreal bevacizumab in retinopathy of prematurity: an interventional case series
Ramak Roohipoor1, Hamed Ghasemi, Fariba Ghassemi
1Eye Research Center, Farabi Eye Hospital, Department of Ophthalmology, Tehran University of Medical Sciences, Qazvin Square, Tehran 1336616351, Iran.
Insights
Intravitreal bevacizumab effectively treated retinopathy of prematurity (ROP) in premature infants, showing rapid regression as adjuvant therapy and a viable alternative for aggressive cases. The treatment was well-tolerated with no major complications observed.
Area of Science:
- Ophthalmology
- Neonatology
- Pharmacology
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Conventional laser therapy for ROP can have limitations and complications.
Purpose of the Study:
- To evaluate the efficacy of intravitreal bevacizumab in achieving regression of retinopathy of prematurity (ROP).
- To assess intravitreal bevacizumab as both an adjuvant and an alternative therapy for ROP management.
Main Methods:
- An interventional case series involving 12 premature infant eyes.
- Two groups: Group 1 received intravitreal bevacizumab (0.625 mg) as adjuvant therapy post-laser; Group 2 received it as initial treatment for aggressive posterior ROP.
Main Results:
- All 8 eyes in Group 1 showed rapid regression within 1 week.
- 3 out of 4 eyes in Group 2 responded initially, with 2 requiring subsequent laser therapy.
- No complications like cataract, endophthalmitis, or retinal detachment were observed during the 1-year follow-up.
Conclusions:
- Intravitreal bevacizumab is well-tolerated in premature infants.
- It effectively induces prompt regression of ROP when used as adjuvant therapy.
- It serves as a potential alternative therapy for aggressive ROP management.
Background:
To evaluate the results of intravitreal bevacizumab in terms of regression of retinopathy of prematurity (ROP).
Methods:
In this interventional case series, 12 eyes from January 2007 to December 2008 were included. Two groups of patients were considered. Group 1 included those ROP patients who did not respond to conventional laser therapy within 3 weeks or had some complications (hyphema or vitreous hemorrhage) after conventional laser therapy; intravitreal injection (0.625 mg) was performed as an adjuvant therapy. Group 2 included those with aggressive posterior ROP who received single intravitreal bevacizumab injection as the initial treatment.
Results:
Ten eyes of 12 patients with mean gestational age of 28.5 (range: 26-32) weeks and birth weight of 1,218 grams (range: 900-1,630) were included in the study. Mean conceptional age at the time of first visit was 40 weeks (30-48 weeks). All the patients had a history of supplemental oxygen. Eight patients (26.3%) were under mechanical ventilation. Eight eyes received bevacizumab after conventional laser therapy (group 1). Four eyes received intravitreal bevacizumab as the initial therapy (group 2). All of the patients were followed up for at least 1 year. All patients in group 1 responded to this adjuvant (intravitreal bevacizumab) treatment within 1 week, but two eyes of group 2 needed laser therapy 1.5 month after intravitreal bevacizumab injection in spite of the initial treatment response. No complications such as cataract, endophthalmitis or retinal detachment occurred.
Conclusions:
The use of intravitreal bevacizumab injection in premature eyes was well-tolerated, and induced prompt regression as an adjuvant therapy after conventional laser therapy and also as an alternative therapy in the management of aggressive retinopathy of prematurity.
