Abstract
Purpose. This study aims to evaluate the regression of retinopathy of prematurity (ROP) after one intravitreal injection of bevacizumab and the factors that influenced it. Methods. This retrospective case series was carried out at the “Iuliu Hațieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania. It includes all the consecutive infants treated for ROP with one intravitreal bevacizumab injection, from January 1, 2009, throughout July 31, 2013. The follow-up continued for 60 weeks after injection. We recorded ROP classification, regression, gender, gestational age, birth weight, postnatal age and postmenstrual age at treatment, and pregnancy type. Regression was analyzed according to each of the abovementioned factors, with the program IBM SPSS 20 (Chicago, Illinois, USA). Results. This study includes 74 eyes of 37 infants of which 52 had aggressive posterior ROP (70.27%) and 22 had zone I stage 3+ ROP (29.72%). One week after the bevacizumab injection, ROP regressed in 63 eyes (85.13%), with a statistically significant higher rate in zone I stage 3+ ROP (100%), as compared with aggressive posterior ROP (78.84%) (P = 0.03). We recorded no complications subsequent to the intravitreal injections of bevacizumab. We identified no late retinal detachment. Conclusion. ROP regression rate after one intravitreal bevacizumab injection was 85.13%. This trial is registered with trial registration number IRCT2014101618966N2.
Highlights
Bevacizumab (Avastin; Genentech Inc., San Francisco, California, USA) is a full anti-VEGF human monoclonal antibody approved in 2004 by the FDA for the treatment of metastatic colon cancer and used off label in the treatment of neovascular retinal diseases, such as retinopathy of prematurity (ROP)[1, 2]
We report our experience with intravitreal bevacizumab over a 55-month period for the treatment of ROP
Stage 3+ ROP and aggressive posterior ROP (AP-ROP) belonging to 37 premature infants, treated by intravitreally injected bevacizumab (Table 1)
Summary
Bevacizumab (Avastin; Genentech Inc., San Francisco, California, USA) is a full anti-VEGF human monoclonal antibody approved in 2004 by the FDA for the treatment of metastatic colon cancer and used off label in the treatment of neovascular retinal diseases, such as retinopathy of prematurity (ROP)[1, 2]. The first reports on the use of bevacizumab for ROP were published in 2007 and they presented the experience in aggressive posterior ROP (AP-ROP) [3,4,5]. This severe form of ROP progresses rapidly to retinal detachment and often has an unfavorable outcome with standard laser treatment [6,7,8,9,10]. The reports on bevacizumab in AP-ROP included a small number of infants, but the finding that the outcomes were better in comparison with the ones of laser brought them into the spotlight. The first prospective case series was published in 2008 and proved neovascular regression after bevacizumab injection, in 17 of the 18 eyes included in the study [11].
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