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Postnatal Growth Trajectories and Neurodevelopmental Outcomes Following Bevacizumab Treatment for Retinopathy of
David L Zhang1, Hawke H Yoon1,2, Raye-Ann O deRegnier3
1Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Insights
Intravitreal bevacizumab (IVB) treatment for retinopathy of prematurity (ROP) showed no significant differences in infant growth or neurodevelopment compared to laser or no treatment. Overall, IVB appears safe for ROP management.
Area of Science:
- Ophthalmology
- Neonatology
- Developmental Pediatrics
Background:
- Retinopathy of prematurity (ROP) is a leading cause of visual impairment in premature infants.
- Intravitreal bevacizumab (IVB) is increasingly used off-label for ROP, but its long-term effects on growth and neurodevelopment require further investigation.
Purpose of the Study:
- To investigate and compare the postnatal growth and neurodevelopmental outcomes in infants with ROP treated with IVB versus laser therapy or spontaneous resolution.
Main Methods:
- A retrospective comparative study included 262 infants with ROP, categorized into IVB treatment, laser treatment, and untreated groups.
- Infants were assessed for weekly weight, height, and head circumference up to 50 weeks postmenstrual age (PMA).
- Neurodevelopment was evaluated using Bayley III scores, and the presence of hearing loss or cerebral palsy was recorded.
Main Results:
- No significant differences in postnatal growth trajectories were observed between the IVB, laser, and untreated groups after adjusting for birth parameters.
- Neurodevelopmental assessments (Bayley scores) also showed no significant differences among the groups.
- While an increased risk of cerebral palsy was noted in the IVB group, it did not reach statistical significance after multiple testing corrections.
Conclusions:
- This study provides evidence that IVB treatment for ROP does not significantly impact longitudinal growth or neurodevelopmental outcomes compared to laser or no treatment.
- The findings support the continued use of IVB as a safe treatment option for retinopathy of prematurity.
- Further research may be warranted to fully elucidate potential long-term neurological effects.
Purpose:
To investigate the postnatal growth and neurodevelopment of infants with retinopathy of prematurity (ROP) treated with intravitreal bevacizumab (IVB).
Patients And Methods:
This was a retrospective comparative study. A total of 262 infants were divided among three study groups: 22 treated with intravitreal bevacizumab, 55 treated with laser, and 185 with ROP that resolved without treatment. Infants with nonviable course or hydrocephalus, a source of non-physiologic weight gain, were excluded. Neurodevelopment was assessed with Bayley III scores at 17-28 months if available and presence of hearing loss or cerebral palsy. Weekly weight, height, and head circumference from birth through 50 weeks postmenstrual age (PMA) were modeled to determine differences in growth trajectories following treatment.
Results:
Comparison of postnatal growth curves from the time of treatment to 50 weeks PMA showed no significant differences in growth trajectories between groups after adjusting for the corresponding growth parameters at birth. Comparison of Bayley scores in patients with available data (n = 120) showed no significant differences. There was an increased risk of cerebral palsy in the IVB group after logistic regression adjusting for baseline confounders, but this did not retain statistical significance after applying the false discovery rate correction for multiple testing.
Conclusion:
To our knowledge, this is the first large retrospective study to examine longitudinal growth in infants treated with IVB compared to controls. There were no significant differences in postnatal growth or neurodevelopmental outcomes between groups, which overall continue to support the safety of bevacizumab treatment for ROP.
