Intravitreal Bevacizumab Injection as a Primary Therapy for Threshold Disease (ROP) in Al Qassim Region

Abstract

Purpose: To evaluate the efficacy and safety of intravitreal injection of bevacizumab without laser as primary therapy in patients with threshold disease in difficulties or lack of facilities for laser as Al Qassim region. Patients and methods: The study included eighteen eyes of nine patients with moderate to severe active ROP (stage III, threshold, or plus disease in zones I and II). For all we gave intravitreal injection of bevacizumab without laser after obtained written consent from the parents, including disclosure of the off-label use of the drug, its unknown safety and efficacy for this indication, and its unknown effects in children. Results: Of 18 eyes enrolled in the study, all have completed 1-year follow-up. Mean birth weight in these infants was 1235 gm, mean gestational age at birth was 28.8 weeks, and mean age at the time of injection was 1.5 months. All eyes showed complete resolution of neovascular plus disease. No patient developed any ocular or systemic complications. In all cases, the ERG and VEP were within normal at 1 year. Conclusions: Intravitreal injection of bevacizumab is an easy, safe and effective modality of therapy for threshold disease ROP especially in presence of difficulties for laser photocoagulation.