Abstract
This single-centered, retrospective cohort study investigated the timing of involution of retinopathy of prematurity (ROP) and retinal vascularization to zone III after intravitreal bevacizumab (IVB) treatment and its possible impacts on postnatal growth and neurodevelopment. Premature infants with birth weight ≤1500 g, born between 2008 to 2014 and diagnosed with ROP were enrolled. All patients with type 1 ROP underwent IVB as 1st line treatment and were recruited as the study group; those with any stage of ROP except type 1 ROP without treatment served as controls. Neurodevelopmental outcomes were assessed using the Bayley Score of Infant Development (BSID) editions II or III. The study group included 35 eyes from 18 patients; the control group included 86 patients. Twenty-three eyes (65.7%) exhibited ROP regression after a single dose of IVB. The majority of plus sign and extraretinal neovascularization regressed within two weeks. The length of time for retinal vascularization to reach zone III was significantly longer in the treatment group compared with the control (mean post-menstruation age 54.5 vs. 47.0 weeks, p<0.001). Long-term follow-up showed no significant differences in body weight and neurodevelopment between the study and control groups up to the 2-year corrected age.
Highlights
Retinopathy of prematurity (ROP) remains a leading cause of childhood blindness
When we pooled all the patients together and compared the incidence of neurodevelopmental impairment, we found there was a trend toward a higher incidence of neurodevelopmental impairment in the bevacizumab-treated group, but this finding was not statistically significant
We observed that 65.7% of the eyes under investigation showed ROP resolution after a single injection
Summary
Retinopathy of prematurity (ROP) remains a leading cause of childhood blindness. Most cases of ROP occur in extremely low-gestational-age neonates (gestational age of less than 28 weeks at birth) [1,2,3,4,5]. Laser photocoagulation is currently the standard of treatment for ROP. The widely-accepted treatment criteria is designated as type 1 ROP, as established in the ETROP study [6, 7]. In 2007, anti–vascular endothelial growth factor (VEGF) intravitreal therapy emerged as a new treatment modality for ROP [8]. The BEATROP (Bevacizumab Eliminates the Angiogenic Threat of Retinopathy of Prematurity) trial showed significant benefits
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