Neurodevelopmental Outcomes Following Bevacizumab Injections for Retinopathy of Prematurity

Abstract

BACKGROUND AND OBJECTIVE: Bevacizumab intravitreal injection, a vascular endothelial growth factor inhibitor, is used to treat retinopathy of prematurity (ROP). However, concerns have been raised regarding its systemic absorption and effect on developing tissues including brain. This study compared neurodevelopment at 18 months' corrected age in preterm infants of <29 weeks' gestation treated with bevacizumab versus laser ablation.

Comparison of Bevacizumab and Ranibizumab in the Treatment of Type 1 Retinopathy of Prematurity Affecting Zone 1

“…In a small series, Martínez-Castellanos et al [50] revealed that IVB did not have a negative effect on ocular and systemic development 5 years after treatment. On the other hand, Morin et al [51] showed that infants treated with IVB had 3.1 times higher odds of neurodevelopmental disabilities. In our study, one patient in the IVB group died because of cardiorespiratory complications.…”

Active surveillance of choroidal neovascularisation in children: incidence, aetiology and management findings from a national study in the UK

“…A more serious concern is whether leakage of anti-VEGF agents into the circulation after intravitreal injection may interact with VEGF receptors in other tissues such as the developing brain. A recent observational study found that infants with ROP who were treated with bevacizumab (had a more severe form of ROP) also had a greater risk of neurodevelopmental disabilities, such as motor delay, compared with those who received laser treatment (but had overall less severe disease) 20. There are no clinical studies that are large enough to evaluate the systemic effects of intravitreal anti-VEGF drugs in children.…”

The Role of Anti-vascular Endothelial Growth Factor Agents in the Management of Retinopathy of Prematurity

“…97 The study was retrospective, relatively small in size and was not randomized, in that infants treated with bevacizumab had more medical issues and potentially prone to neurocognitive delays. Nonetheless, the study raises important safety concerns of anti-VEGF therapy.…”