Related Experiment Video
Updated: Mar 20, 2026
Monitoring Dynamic Growth of Retinal Vessels in Oxygen-Induced Retinopathy Mouse Model
Published on: April 2, 2021
Neurodevelopmental Outcomes Following Bevacizumab Injections for Retinopathy of Prematurity
Julie Morin1, Thuy Mai Luu2, Rosanne Superstein1
1Department of Pediatrics and Ophthalmology, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Canada;
Insights
Bevacizumab treatment for retinopathy of prematurity in preterm infants was associated with higher odds of severe neurodevelopmental disabilities compared to laser therapy. Further research is needed on the long-term safety of anti-vascular endothelial growth factor treatments.
Area of Science:
- Neonatal care
- Ophthalmology
- Neurodevelopmental pediatrics
Background:
- Bevacizumab (Avastin) is used to treat retinopathy of prematurity (ROP).
- Concerns exist regarding systemic absorption and effects on infant neurodevelopment.
- This study compares neurodevelopmental outcomes in preterm infants treated with bevacizumab versus laser therapy for ROP.
Purpose of the Study:
- To compare neurodevelopmental outcomes at 18 months corrected age in preterm infants (<29 weeks gestation) treated for ROP with bevacizumab versus laser ablation.
- To assess the safety and efficacy of intravitreal bevacizumab in this vulnerable population.
Main Methods:
- Retrospective review of data from Canadian Neonatal Network and Follow-Up Network databases (2010-2011).
- Included preterm infants (<29 weeks gestation) treated for ROP.
- Neurodevelopmental assessment at 18 months corrected age using neurologic examination and Bayley Scales of Infant and Toddler Development Third Edition.
- Regression analyses were performed to adjust for confounding factors.
Main Results:
- 27 infants received bevacizumab, 98 received laser therapy.
- Bevacizumab group had lower median motor (81 vs 88) and language (79 vs 89) composite scores on the Bayley Scales.
- No significant difference in cognitive scores.
- Odds of severe neurodevelopmental disabilities were 3.1 times higher in the bevacizumab group (95% CI: 1.2-8.4) after adjusting for multiple factors.
Conclusions:
- Preterm infants treated with bevacizumab for ROP showed increased odds of severe neurodevelopmental disabilities compared to those treated with laser.
- Long-term safety of anti-vascular endothelial growth factor (anti-VEGF) treatment for ROP requires further investigation.
- Findings suggest caution and highlight the need for continued monitoring of neurodevelopmental outcomes in infants receiving bevacizumab.
Background And Objective:
Bevacizumab intravitreal injection, a vascular endothelial growth factor inhibitor, is used to treat retinopathy of prematurity (ROP). However, concerns have been raised regarding its systemic absorption and effect on developing tissues including brain. This study compared neurodevelopment at 18 months' corrected age in preterm infants of <29 weeks' gestation treated with bevacizumab versus laser ablation.
Methods:
Data from the Canadian Neonatal Network and the Canadian Neonatal Follow-Up Network databases were retrospectively reviewed. Infants born at <29 weeks' in 2010-2011 with treated ROP were studied. Neurodevelopmental outcome at 18 months was assessed by using neurologic examination and the Bayley Scales of Infant and Toddler Development Third Edition. Regression analyses were performed.
Results:
Of 125 treated infants, 27 received bevacizumab and 98 laser. The bevacizumab group, compared with laser, obtained a median Bayley Scales of Infant and Toddler Development Third Edition motor composite score of 81 (interquartile range, 70-91) versus 88 (79-97), a language composite score of 79 (65-97) versus 89 (74-97), and a cognitive score of 90 (80-100) versus 90 (85-100). Difference was detected on the motor score only (P = .02). Odds of severe neurodevelopmental disabilities (Bayley scores <70, severe cerebral palsy, hearing aids, or bilateral blindness) was 3.1 times higher (95% confidence interval: 1.2-8.4) in infants treated with bevacizumab versus laser after adjusting for gestational age, gender, maternal education, Score for Neonatal Acute Physiology-II score, bronchopulmonary dysplasia, sepsis, and severe brain injury.
Conclusions:
Preterm infants treated with bevacizumab versus laser had higher odds of severe neurodevelopmental disabilities. Further investigation on the long-term safety of antivascular endothelial growth factor treatment of ROP is needed.
