Intravitreal bevacizumab as adjunctive treatment for retinopathy of prematurity

Law, Janice C.; Recchia, Franco M.; Morrison, David G.; Donahue, Sean P.; Estes, Robert L.

doi:10.1016/j.jaapos.2009.10.011

Cited by 77 publications

(54 citation statements)

References 21 publications

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“…Intravitreal injection of anti-VEGF drugs, primarily bevacizumab (Avastin), which stabilizes neovascular formation, is thought to be useful for treating ROP. [18][19][20] However, the efficacy of the drug as therapy for AP-ROP is not well established. Monotherapy administered to avoid photocoagulation in the treatment of ROP 18 may not stabilize severe ROP involving the entire retina that is hypoperfused in the presence of a large amount of VEGF.…”

Section: Discussionmentioning

confidence: 99%

“…Monotherapy administered to avoid photocoagulation in the treatment of ROP 18 may not stabilize severe ROP involving the entire retina that is hypoperfused in the presence of a large amount of VEGF. Relatively good outcomes after anti-VEGF therapy combined with other surgical interventions have been reported recently, such as salvage therapy that prevents progression of retinal detachments after application of photocoagulation 19 and an adjunctive therapy to achieve a dilatory effort before planned vitreous surgery, 20 for which some problems remain to be addressed. Contraction of FT, an adverse drug effect that promotes retinal dragging and detachment, 21 is critical when the FT is extensive.…”

Section: Discussionmentioning

confidence: 99%

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Visual Outcomes After Early Vitreous Surgery for Aggressive Posterior Retinopathy of Prematurity

et al. 2013

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IMPORTANCE Aggressive posterior retinopathy of prematurity (AP-ROP) rapidly progresses to retinal detachment despite application of photocoagulation. Early vitreous surgery might achieve prompt regression of neovascular activity and a high incidence of retinal reattachment.OBJECTIVE To evaluate visual outcomes in eyes with AP-ROP after early vitreous surgery.DESIGN Retrospective nonrandomized study of patients who underwent early vitreous surgery with lensectomy when retinal detachment developed despite photocoagulation. Aphakic correction with spectacles or contact lenses and the use of orthoptics were continued postoperatively. The best-corrected visual acuity (VA) was measured in eyes with a total retinal reattachment using the preferential looking technique in patients ranging in age from 8 months to no more than 3 years and a VA chart with Landolt rings or pictures for older children. The VA findings were converted to Snellen lines.SETTING Institutional ophthalmology practice.PARTICIPANTS Of the 103 eyes (57 patients) that underwent early vitreous surgery for AP-ROP, the VA was measured in 58 (32 patients) at a corrected age ranging from 8 months to 4 years. INTERVENTIONSEarly vitreous surgery and VA measurement using the preferential looking technique and a VA chart. MAIN OUTCOMES AND MEASURESPostoperative VA, ROP stage, extent of fibrovascular tissue (FT) growth, and laterality of the eyes that underwent surgery. RESULTSThe VAs ranged from 20/2000 to 20/40. The VA may not be related to the preoperative ROP stage 4A or 4B but may depend on the preoperative extent of FT growth. In 39 of 58 eyes (67.2%), the FT had not reached the vitreous base preoperatively, and foveal formation occurred postoperatively with nearly age-appropriate VA (range, 20/250 to 20/40). In 17 of 58 eyes (29.3%), the FT had reached the vitreous base, and no fovea formed (VA range, 20/2000 to 20/250). Two of 58 eyes (3.4%) had deprivation amblyopia with a VA worse than 20/1600. The difference in VA between both eyes of patients who underwent bilateral vitreous surgery depended on ROP progression; patients who underwent a unilateral procedure in which the fellow eyes with ROP stabilized after photocoagulation tended to have poor vision because of deprivation amblyopia. CONCLUSIONS AND RELEVANCEEarly vitreous surgery may be beneficial for AP-ROP and should be performed before the FT reaches the vitreous base to facilitate foveal formation and good VA outcomes. The roles of photocoagulation, vitreous surgery, and anti-vascular endothelial growth factor therapy in the treatment of AP-ROP should be investigated in randomized trials regarding efficacy, safety, convenience, and cost.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Visual Outcomes After Early Vitreous Surgery for Aggressive Posterior Retinopathy of Prematurity

et al. 2013

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“…In addition, they are already considered a valuable adjunct in other conditions such as PDR and NVG with ongoing studies that may further define their role and benefits. Antiangiogenic agents have been used successfully in the treatment of sickle cell retinopathy (Siqueira et al 2006), retinopathy of prematurity (Altinsoy et al 2010;Law et al 2010), radiation retinopathy (Gupta and Muecke 2008) and other similar proliferative retinal vascular diseases. However, the long-term safety and potential toxicity of chronic VEGF inhibition needs to be closely monitored.…”

Section: Discussionmentioning

confidence: 99%

Antiangiogenic Therapy for Ischemic Retinopathies

Al-Latayfeh¹,

Silva²,

Sun³

et al. 2012

Cold Spring Harbor Perspectives in Medicine

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“…3 Moreover, bevacizumab injection is a short procedure that only requires topical anesthetic, 9 though some physicians, to minimize risk of lens injury due to infant movement, prefer using intravenous sedation. 10,11 So far, the long-term safety of bevacizumab has not been examined. Given the prolonged halflife of bevacizumab and its potential antiangiogenic effect beyond the eye, it is crucial to document the whole-body effects of this drug, especially in preterm infants who are still undergoing organogenesis.…”

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confidence: 99%

Neurodevelopmental Outcomes Following Bevacizumab Injections for Retinopathy of Prematurity

et al. 2016

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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.

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Intravitreal bevacizumab as adjunctive treatment for retinopathy of prematurity

Cited by 77 publications

References 21 publications

Visual Outcomes After Early Vitreous Surgery for Aggressive Posterior Retinopathy of Prematurity

Visual Outcomes After Early Vitreous Surgery for Aggressive Posterior Retinopathy of Prematurity

Antiangiogenic Therapy for Ischemic Retinopathies

Neurodevelopmental Outcomes Following Bevacizumab Injections for Retinopathy of Prematurity

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