Safety and efficacy of preoperatively intravitreal injection of bevacizumab for stage 4 retinopathy of prematurity

Abstract

Objective To observe the safety and efficacy of bevacizumab pretreatment in vitrectomy for vascularly active stage 4 retinopathy of prematurity (ROP).Methods A retrospective case series of 16eyes of 8 patients with vascularly active stage 4 ROP who received an intravitreal injection of bevacizumab were studied.An intravitreal injection of 0.625 mg bevacizumab was performed one week prior to planned vitrectomy.Five days after injection,the eyes were examined by indirect ophthalmoscopy and documented with fundus photography using a RetCam Ⅱ to evaluate the vascular activity.Lens-sparing vitrectomy was performed in 14 eyes,while vitrectomy combined with lensectomy was performed in 2 eyes,one week after the injection.Three months after vitrectomy,the retinal status and lens clarity were observed.Results All patients showed remarkable regression of the fibrovascular membrane with clinically absent vascular component 5 days after the injection. No adverse events occurred. Three months after vitrectomy,anatomical attachment was achieved in 15 eyes (93.75 ％ ),1 eye (6.25 ％ ) had partial attachment.The lens remained clear in all the eyes. Conclusion Intravitreal bevacizumab administrated prior to vitrectomy reduced neovascularization safely and effectively for stage 4 ROP. Key words: Retinopathy of prematurity/drug therapy; Antibodies, monoclonal/therapeutic use; Vitrectomy