Related Experiment Video
Updated: Nov 29, 2025
Monitoring Dynamic Growth of Retinal Vessels in Oxygen-Induced Retinopathy Mouse Model
Published on: April 2, 2021
Neurodevelopmental Outcomes after Bevacizumab Treatment for Retinopathy of Prematurity: A Meta-analysis
Chia-Ying Tsai1, Po-Ting Yeh2, Po-Nien Tsao3
1Department of Ophthalmology, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan; School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan; Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.
Insights
Intravitreal bevacizumab (IVB) for retinopathy of prematurity (ROP) does not increase the risk of severe neurodevelopmental impairment (sNDI). Neurodevelopmental outcomes, including Bayley III scores, were similar between ROP infants treated with IVB and controls.
Area of Science:
- Ophthalmology
- Neonatology
- Neurodevelopmental Pediatrics
Background:
- Intravitreal bevacizumab (IVB) is used to treat retinopathy of prematurity (ROP).
- Concerns exist regarding potential systemic side effects of IVB, particularly severe neurodevelopmental impairment (sNDI).
- Existing research on neurodevelopmental outcomes after IVB in ROP infants presents conflicting results.
Purpose of the Study:
- To evaluate and compare neurodevelopmental outcomes in infants with ROP treated with IVB versus those not exposed to IVB.
- To assess the risk of severe neurodevelopmental impairment (sNDI) following IVB therapy in ROP patients.
Main Methods:
- A meta-analysis was conducted, searching PubMed, Embase, and Web of Science for comparative studies.
- Included studies compared ROP patients treated with IVB to control groups without IVB, reporting on neurodevelopmental outcomes like sNDI, Bayley III scores, and cerebral palsy (CP).
- Primary outcome was sNDI (odds ratio), with secondary outcomes including Bayley III cognitive, language, and motor scores (mean differences) and CP (odds ratio).
Main Results:
- Eight studies were included in the meta-analysis.
- The weighted odds ratio for sNDI in the IVB group was 1.39 (95% CI, 0.98-1.97), indicating no statistically significant increase.
- Bayley III scores showed no significant differences, except for a minor decrease in motor scores (MD -3.66; 95% CI, -6.79 to -0.54). The odds ratio for CP was 1.20 (95% CI, 0.56-2.55).
Conclusions:
- The risk of severe neurodevelopmental impairment (sNDI) is not elevated in retinopathy of prematurity (ROP) infants treated with intravitreal bevacizumab (IVB).
- Neurodevelopmental outcomes, assessed by Bayley III scores, were comparable between IVB-treated and control ROP infants, with a slight motor deficit noted.
- While findings suggest a low risk of sNDI with IVB, randomized trials are recommended to strengthen the evidence base.
Purpose:
To evaluate neurodevelopmental outcomes after intravitreal bevacizumab (IVB) therapy in retinopathy of prematurity (ROP) infants compared with those not exposed to IVB.
Clinical Relevance:
The primary concern regarding IVB treatment of ROP is the potential systemic side effects, especially the risk of causing severe neurodevelopmental impairment (sNDI). Results regarding neurodevelopmental outcomes after IVB therapy are conflicting.
Methods:
We conducted a meta-analysis and searched PubMed, Embase, and Web of Science for related publications from inception through March 12, 2020. The eligibility criteria were as follows: comparative studies of ROP patients that (1) included IVB as a treatment arm, (2) included a control group without bevacizumab treatment, and (3) reported on at least 1 neurodevelopmental outcome, such as sNDI, Bayley Scales of Infant and Toddler Development, Third Edition (Bayley III), composition scores, or cerebral palsy (CP). The primary outcome was sNDI, with the odds ratio (OR) calculated. Secondary outcomes were mean differences (MDs) for cognitive, language, and motor scores (Bayley III) and OR for CP. The quality of evidence was assessed using the Grades of Recommendation, Assessment, Development, and Evaluation approach.
Results:
Eight studies, 6 including laser-controlled ROP infants and 2 including ROP infants not requiring treatment, were included. The weighted OR for sNDI in the IVB group was 1.39 (95% confidence interval [CI], 0.98-1.97). The weighted MDs were -1.92 (95% CI, -4.73 to 0.88), -1.32 (95% CI, -4.65 to 1.99), and -3.66 (95% CI, -6.79 to -0.54) for cognitive, language, and motor scores in Bayley III, respectively. The OR for CP was 1.20 (95% CI, 0.56-2.55). No differences were observed between the preset subgroups comprising laser-controlled ROP infants and ROP infants not requiring treatment. The current quality of evidence was rated as low (sNDI and all Bayley III scores) to very low (CP).
Conclusions:
Risk of sNDI was not increased in ROP patients after IVB treatment. Bayley III scores were similar in the IVB and control groups, except for a minor difference in motor performance. These findings suggest that the risk of additional sNDI after IVB treatment is low. Randomized trials are warranted to provide a higher quality of evidence.
