Evaluation of Infants with Retinopathy of Prematurity Treated with Intravitreal Bevacizumab

Abstract

Objective: To evaluate the systemic and local effects and side effects of intravitreal bevacizumab injection in preterm infants with aggressive posterior retinopathy of prematurity.Material and Methods: A total of 16 patients were included in this single-center observational cohort study between June 2020 and March 2021. The clinical, laboratory, and radiological findings before and after intravitreal injection of 0.3 mg bevacizumab were recorded for a total of 32 eyes. Results:The patients' mean gestational age at birth was 25±0.38 weeks and their mean birth weight was 695±119.2 g. None of the patients developed complications such as local vitreous hemorrhage or endophthalmitis secondary to intravitreal injection administered at a postmenstrual age of 34 weeks, and none required repeated injections. There was no increase in the rate of intraventricular hemorrhage after injection. There was no statistically significant difference in the patients' laboratory parameters, blood pressure values, or systemic findings before and after treatment. Conclusion:Although no systemic or local side effects were observed in patients treated with intravitreal bevacizumab injection in this study, patients should be monitored closely for systemic hypertension, intraventricular hemorrhage, and hypotension. More detailed studies are needed to evaluate later neurodevelopmental outcomes compared to other treatment options.

Being Small for Gestational Age Affect Neurodevelopmental Outcomes in Very Preterm Infants

“…Fetal malnutrition in periods of critical cell development may cause permanent alterations in various organs, including the brain. A correlation between GW and cognitive function has been posited in the literature (17). There are also studies indicating that preterm SGA infants have lower Bayley scores (19).…”

“…The following data was obtained from the medical records: GA, BW, head circumference at birth, sex, maternal age, maternal hypertension and diabetes history, multiple pregnancy, antenatal steroid (ANS) use, mode of delivery, prolonged premature rupture of membranes (pPROM), first and fifth minute Apgar scores, respiratory distress syndrome (RDS; need for surfactant) (10), hemodynamically significant patent ductus arteriosus (PDA; was diagnosed according to echocardiography performed between 24 and 72 hours (left atrium/aortic root >1.5 and/or ductus diameter >1.5 mm) (11), early-onset neonatal sepsis (ENS; sepsis on first 3 postnatal days) (12), cultureproven late-onset neonatal sepsis (LOS; sepsis after 3 rd postnatal day) (13), necrotizing enterocolitis (NEC; was diagnosed according to laboratory, clinical, and radiological findings and was staged according to the modified Bell criteria, Bell stage ≥ IIb) (14), intraventricular hemorrhage (IVH; grade ≥3, cranial ultrasound imaging results were based on the worst finding at any given time for this patient before discharge) and periventricular leukomalacia (PVL) (15), oxygen levels, non-invasive respiratory support, mechanical ventilation (MV) durations, bronchopulmonary dysplasia (BPD; BPD was defined using the classification developed through a National Institutes of Health Workshop and reported by Jobe and Bancalari moderate/severe) (16), retinopathy of prematurity (ROP; was defined according to the International Classification of Retinopathy of Prematurity (ICROP) (17), postnatal corticosteroid treatment and length of NICU stay. These clinical and demographic characteristics were evaluated and compared between SGA and AGA patients.…”