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Neurodevelopmental Outcomes after Intravitreal Bevacizumab Therapy for Retinopathy of Prematurity: A Prospective
Yuan-Yao Fan1, Yu-Shu Huang2, Chung-Ying Huang3
1Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Insights
Intravitreal bevacizumab injection (IVB) for retinopathy of prematurity (ROP) showed similar neurodevelopmental and ocular outcomes compared to untreated ROP. Premature children treated with IVB did not experience worse outcomes in this study.
Area of Science:
- Ophthalmology
- Neonatology
- Developmental Pediatrics
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Intravitreal bevacizumab injection (IVB) is used to treat severe ROP, but its long-term effects on neurodevelopment and ocular outcomes require evaluation.
Purpose of the Study:
- To assess and compare the neurodevelopmental and ocular developmental outcomes of premature children treated with IVB for type 1 ROP against control groups.
- To determine if IVB treatment for ROP impacts long-term visual function and cognitive development.
Main Methods:
- A prospective case-control study involving 148 premature infants divided into three groups: no ROP, ROP without treatment, and ROP treated with IVB.
- Ocular assessments included cycloplegic refractometry, axial length, and Cardiff acuity.
- Neurodevelopmental assessment utilized the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley III).
Main Results:
- Infants treated with IVB (group 2) showed significantly more myopia and poorer Cardiff acuity compared to those without ROP (group 0).
- No significant differences in refractive status, axial length, or Cardiff acuity were found between the IVB-treated group (group 2) and the untreated ROP group (group 1).
- Neurodevelopmental assessments (Bayley III) revealed no significant differences among the three groups after adjusting for gestational age and other risk factors.
Conclusions:
- Premature children treated with IVB for ROP demonstrated comparable neurodevelopmental and ocular outcomes to those with ROP who did not receive treatment.
- While IVB treatment did not lead to worse outcomes, the study acknowledges the possibility of detecting small, clinically significant differences.
- The findings support the safety of IVB regarding neurodevelopmental and visual outcomes in the context of ROP management.
Purpose:
To evaluate the neurodevelopmental and ocular developmental outcomes in premature children who have undergone intravitreal bevacizumab injection (IVB) for treatment of type 1 retinopathy of prematurity (ROP).
Design:
Prospective case-control study.
Participants:
We enrolled 3 groups of premature patients: premature children who had no history of ROP (group 0), premature children with history of ROP without treatment (group 1), and premature children with ROP who had received a single IVB (0.625 mg; group 2).
Methods:
Ocular developmental assessment, including cycloplegic refractometry, axial length, Cardiff acuity, and neurodevelopmental assessment via the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley III), were performed at 1 to 3 years of age and were compared between groups.
Main Outcome Measures:
Ocular developmental outcomes and Bayley III scores.
Results:
A total of 148 patients (85 boys and 63 girls) were included. The mean age at assessment was 1.49±0.59 years. Group 0 patients demonstrated significantly higher gestational age (GA), birth weight, and Apgar scores compared with group 1 and 2 patients. There were no significant differences between groups 1 and 2 in demographics or systemic risk factors except for lower GA in group 2. The cylindrical power was significantly larger in groups 1 and 2 compared with group 0. The spherical equivalent was significantly more myopic and the Cardiff acuity was significantly poorer in group 2 than in group 0. There were no significant differences between groups 1 and 2 in refractive status, axial length, or Cardiff acuity. Neurodevelopmental assessment using Bayley III showed no significant difference among the 3 groups in any aspect after adjusting for GA and other systemic risk factors. The risks for poor neurodevelopmental outcomes also were not significantly different.
Conclusions:
At the mean age of 1.5 years, children with prior history of IVB (group 2) showed similar refractive and visual outcomes and similar neurodevelopmental outcomes compared with premature patients with ROP without requirement of treatment (group 1), although there is a possibility that a small but clinically significant difference may not have been detected in the current study.
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