Abstract
PurposeThe purpose of this study was to evaluate neurodevelopmental outcomes in 18-month old (corrected age) preterm infants who received an intravitreal bevacizumab (IVB) injection for the treatment of type 1 retinopathy of prematurity (ROP).MethodsIn this ten-year retrospective study, we reviewed the medical records of patients who underwent ROP screening at Kyushu University Hospital. Among the patients who received IVB or laser photocoagulation (LPC) for the treatment of type 1 ROP, we included infants whose neurodevelopmental examination (the Kyoto Scale of Psychological Development [KSPD]) results at 18 months corrected age were available. Then, the effect of IVB on the developmental quotient (DQ) in each KSPD domain (Postural-Movement, Cognitive-Adaptive, or Language-Social domain) or the overall DQ was investigated by performing linear regression analysis.ResultsOut of the 513 patients reviewed, 53 were included in the study. IVB and LPC were performed for 14 and 39 patients, respectively. Administration of IVB was significantly associated with neurodevelopmental delay in the Language-Social domain (p = 0.01). The observed association remained even after adjusting for gestational age and birth weight (p = 0.03).ConclusionsAdministration of IVB may introduce a risk of developmental impairment of interpersonal relationships, socializations, and/or verbal abilities of preterm children. We recommended that preterm infants who received IVB undergo a neurodevelopmental reassessment during their school years or in adulthood.
Highlights
Retinopathy of prematurity (ROP) is a retinal vasoproliferative disease that can lead to childhood blindness [1]
The therapeutic efficacy of laser photocoagulation (LPC) was established by the Early Treatment for ROP (ETROP) Study [7]
Compared to LPC, the intravitreal bevacizumab (IVB) treatment resulted in a lower recurrence rate of zone I ROP
Summary
Retinopathy of prematurity (ROP) is a retinal vasoproliferative disease that can lead to childhood blindness [1]. The initial standard treatment for ROP is laser photocoagulation (LPC) or intravitreal injection of an anti-vascular endothelial growth factor (VEGF) agent [6,7]. Compared to LPC, the IVB treatment resulted in a lower recurrence rate of zone I ROP. Another advantage of IVB is that it is a less invasive treatment method for preterm infants, because the time needed for the IVB procedure is less than that needed to perform LPC. The off-label use of IVB is relatively established as a primary treatment method for severe ROP or general unstable conditions in preterm infants [9,10]
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