Intravitreal Bevacizumab for Retinopathy of Prematurity: Refractive Error Results

Abstract

To evaluate refractive error in infants who underwent intravitreal bevacizumab injection for treatment of threshold retinopathy of prematurity (ROP). Retrospective nonrandomized interventional comparative study. The study group included all infants who consecutively received a single intravitreal bevacizumab (0.375mg or 0.625mg) injection for therapy of threshold ROP in fundus zone I or zone II. The control group included infants who had previously undergone retinal argon laser therapy of ROP. The follow-up examination included refractometry under cycloplegic conditions. The study group included 12 children (23 eyes; mean birth weight: 622 ± 153 g; gestational age: 25.2 ± 1.6weeks) and the control group included 13 children (26 eyes; birth weight: 717 ± 197 g; gestational age: 25.3 ± 1.8weeks). Both groups did not differ significantly in birth age and weight and follow-up. At the end of follow-up at 11.4 ± 2.3months after birth, refractive error was less myopic in the study group than in the control group (-1.04 ± 4.24 diopters [median: 0 diopters] vs-4.41 ± 5.50 diopters [median:-5.50 diopters]; P= .02). Prevalence of moderate myopia (17% ± 8% vs 54% ± 10%; P= .02; OR: 0.18 [95% CI: 0.05, 0.68]) and high myopia (9% ± 6% vs 42% ± 10%; P= .01; OR: 0.13 [95% CI: 0.03, 0.67]) was significantly lower in the bevacizumab group. Refractive astigmatism was significantly lower in the study group (-1.0 ± 1.04 diopters vs 1.82 ± 1.41 diopters; P= .03). In multivariate analysis, myopic refractive error and astigmatism were significantly associated with laser therapy vs bevacizumab therapy (P=.04 and P= .02, respectively). In a 1-year follow-up, a single intravitreal bevacizumab injection as compared to conventional retinal laser coagulation was helpful for therapy of ROP and led to less myopization and less astigmatism.