Very Late Reactivation of Retinopathy of Prematurity After Monotherapy With Intravitreal Bevacizumab

The authors report a case of very late reactivation of retinopathy of prematurity (ROP) after bevacizumab monotherapy. A female born at 630 g and 24 weeks received two bilateral treatment of bevacizumab (Avastin; Genentech, South San Francisco, CA) for aggressive posterior ROP (APROP). At 2.5 years of age, ROP reactivated in the form of tractional retinal detachment in one eye and milder reactivation in the other. Although intravitreal bevacizumab treatment is effective in inducing regression of ROP, late reactivation and retinal detachments can occur after initial extended quiescence. Due to alterations of disease progression after bevacizumab, close follow-up by peripheral fluorescein angiography and laser ablation of persistent avascular retina is recommended to prevent disease reactivation and progression to retinal detachment.