Intravitreal low‐dosage bevacizumab for retinopathy of prematurity

Abstract

To report on the therapeutic effect of intravitreal low-dose bevacizumab for treatment for retinopathy of prematurity (ROP). The single-centre retrospective, non-comparative case series study included all infants who consecutively underwent intravitreal injection of 0.375mg bevacizumab (0.03ml) under light sedation in topical anaesthesia as therapy of ROP in zone I or zone II. The clinical charts of 29 patients (57 eyes) with a median birth weight of 630g (range: 290-1390g) and median gestational age of 25+1weeks (range: 23+1-30weeks) were reviewed. Six children (12 eyes) were graded as ROP with zone I retinopathy and plus disease. The 23 remaining infants had extraretinal neovascularizations in zone II or partly zone I. The intravitreal bevacizumab injection was injected at a median age of 12+1weeks (range: 7+4-21+4), the median follow-up was 4.2months (range: from 3days to 45.1months). In all eyes treated, a regression of plus disease occurred within two to six days, retinal neovascularizations regressed within 2-3weeks and pupillary rigidity improved. None except one child in exceptionally bad general health conditions needed a second intravitreal bevacizumab injection. In none of the infants, any ophthalmologic side-effects of the bevacizumab application were detected during the follow-up period. The intravitreal injection of a low dose of 0.375mg bevacizumab showed a high efficacy as treatment for ROP. The question arises whether the low dosage of bevacizumab as compared to the dosage of 0.625mg bevacizumab may be preferred.