Intravitreal bevacizumab in retinopathy of prematurity: an interventional case series

Background To evaluate the results of intravitreal bevacizumab in terms of regression of retinopathy of prematurity (ROP). Methods In this interventional case series, 12 eyes from January 2007 to December 2008 were included. Two groups of patients were considered. Group 1 included those ROP patients who did not respond to conventional laser therapy within 3 weeks or had some complications (hyphema or vitreous hemorrhage) after conventional laser therapy; intravitreal injection (0.625 mg) was performed as an adjuvant therapy. Group 2 included those with aggressive posterior ROP who received single intravitreal bevacizumab injection as the initial treatment. Results Ten eyes of 12 patients with mean gestational age of 28.5 (range: 26–32) weeks and birth weight of 1,218 grams (range: 900–1,630) were included in the study. Mean conceptional age at the time of first visit was 40 weeks (30–48 weeks). All the patients had a history of supplemental oxygen. Eight patients (26.3%) were under mechanical ventilation. Eight eyes received bevacizumab after conventional laser therapy (group 1). Four eyes received intravitreal bevacizumab as the initial therapy (group 2). All of the patients were followed up for at least 1 year. All patients in group 1 responded to this adjuvant (intravitreal bevacizumab) treatment within 1 week, but two eyes of group 2 needed laser therapy 1.5 month after intravitreal bevacizumab injection in spite of the initial treatment response. No complications such as cataract, endophthalmitis or retinal detachment occurred. Conclusions The use of intravitreal bevacizumab injection in premature eyes was well-tolerated, and induced prompt regression as an adjuvant therapy after conventional laser therapy and also as an alternative therapy in the management of aggressive retinopathy of prematurity