Low-Dose Bevacizumab 0.03 mg for Treatment of Type 1 Retinopathy of Prematurity

We reviewed outcomes using intravitreal bevacizumab 0.03 mg to treat retinopathy of prematurity (ROP) after switching to this dose in November 2018.

Multicenter, retrospective, nonrandomized, nonmasked, consecutive case series.

This study included 62 premature infants (123 eyes) diagnosed with type 1 ROP who were treated with low-dose bevacizumab (0.03 mg). A historical control group of infants who had received standard-dose bevacizumab (0.625 mg) was included for comparison.

Results from 62 patients (123 eyes) treated between November 2018 and September 2023 with low-dose intravitreal bevacizumab, 0.03 mg in 0.03 ml, by 4 treating physicians were reviewed.

Primary outcome measures were percentage of eyes having initial regression of ROP and percentage of eyes that received subsequent laser treatment. Secondary outcomes were time between bevacizumab and subsequent laser treatment, number of laser spots, and percentage with recurrence of ROP.

All eyes had initial regression of ROP. Of the 123 eyes, 42 (34%) received laser treatment at some point after bevacizumab: 34 (28%) for persistent avascular retina (PAR) and 8 (7%) for reactivation of ROP. The average time between bevacizumab and laser was 16 ± 6 weeks for PAR and 13 ± 5.8 weeks for recurrent ROP. The mean number of laser spots per eye was 496 ± 247 for PAR and 905 ± 915 for recurrent ROP (P = 0.028). No eyes developed stage 4 or stage 5 ROP.

Based on historical comparisons, a 0.03-mg dose of intravitreal bevacizumab was as effective as a 0.625-mg dose for treatment of ROP. These data provide additional evidence from clinical practice to support the use of a 0.03-mg dose of bevacizumab for treatment of ROP.

Proprietary or commercial disclosures may be found in the Footnotes and Disclosures at the end of this article.