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Neurodevelopmental outcomes in infants treated with intravitreal bevacizumab versus laser

Kamini Raghuram1, Maram Isaac2, Junmin Yang3

  • 1Division of Neonatology, Department of Pediatrics, University of Toronto, Toronto, ON, Canada.

Journal of Perinatology : Official Journal of the California Perinatal Association
|July 26, 2019
PubMed

Insights

Intravitreal bevacizumab (IVB) showed no significant differences in neurodevelopmental impairment (NDI) compared to laser ablation in preterm infants. Further research is needed to confirm the long-term safety and efficacy of IVB in neonates.

Area of Science:

  • Neonatal ophthalmology
  • Developmental pediatrics

Background:

  • Retinopathy of prematurity (ROP) is a leading cause of visual impairment in preterm infants.
  • Intravitreal bevacizumab (IVB) and laser ablation are common treatments for ROP.
  • Long-term neurodevelopmental and visual outcomes following these treatments require further investigation.

Purpose of the Study:

  • To compare neurodevelopmental and visual outcomes in preterm infants treated with IVB versus laser ablation.
  • To assess neurodevelopmental impairment (NDI) and significant NDI (sNDI) at 18-24 months corrected age.
  • To evaluate structural and refractive visual outcomes.

Main Methods:

  • Retrospective study comparing 34 infants (60 eyes) treated with IVB and 30 infants (51 eyes) treated with laser.
  • Primary outcome: NDI. Secondary outcomes: sNDI, cerebral palsy, hearing loss, Bayley Scales of Infant Development III scores, and visual outcomes.
  • Statistical analysis included adjusted odds ratios (AOR) controlling for gestational age, sex, and ROP severity.

Main Results:

  • No significant differences were found in NDI (AOR 1.77) or sNDI (AOR 2.31) between the IVB and laser groups.
  • No other significant differences in neurodevelopmental or visual outcomes were observed.
  • The study included infants treated for retinopathy of prematurity.

Conclusions:

  • Current evidence suggests comparable neurodevelopmental and visual outcomes between IVB and laser treatment for ROP in preterm infants at 18-24 months corrected age.
  • Larger randomized trials are necessary to definitively establish the long-term efficacy and safety of IVB in this population.
  • IVB may be a viable alternative to laser ablation, but further research is warranted.
Abstract

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