Bevacizumab in Retinopathy of Prematurity : Concerns and adverse effects

Area of Science:

• Ophthalmology
• Neonatology
• Vascular Biology

Background:

• Retinopathy of prematurity (ROP) is a leading cause of blindness in children, with increasing incidence globally.
• Vascular Endothelial Growth Factor (VEGF) is implicated in the pathogenesis of ROP, a significant vasoproliferative disorder in premature infants.

Purpose of the Study:

• To review and discuss potential complications associated with anti-VEGF agents, specifically intravitreal bevacizumab, in the management of Retinopathy of Prematurity.
• To highlight the need for comprehensive analysis of adverse effects prior to routine clinical application.

Main Methods:

• Literature review of studies on anti-VEGF agents for ROP treatment.
• Analysis of case studies, case series, and the BEAT-ROP randomized controlled trial.
• Focus on complications reported before the widespread adoption of intravitreal bevacizumab.

Main Results:

• Evidence for anti-VEGF efficacy in ROP treatment exists since 2007, primarily from limited case reports.
• The BEAT-ROP study (2011) is the sole randomized controlled trial, but it did not analyze adverse effects of bevacizumab.
• Complications associated with intravitreal bevacizumab in ROP management require thorough investigation.

Conclusions:

• Anti-VEGF therapy, particularly intravitreal bevacizumab, shows promise for ROP but necessitates careful consideration of potential adverse events.
• Further research is crucial to fully understand and mitigate the risks associated with bevacizumab treatment in premature infants.
• A comprehensive review of complications is needed before the blanket administration of intravitreal bevacizumab for ROP.