Intravitreal Bevacizumab in Aggressive Posterior Retinopathy of Prematurity

Abstract

<P>The anatomic response to intravitreal bevacizumab injection in three patients with aggressive, posterior retinopathy of prematurity is described. In all cases, the worse eye was treated with a single intravitreal injection of 0.75 mg of bevacizumab as monotherapy or complementary to laser therapy. In 24 hours, all injected eyes showed regression of the tunica vasculosa lentis and iris vessel engorgement and disappearance of iris rigidity. In addition, plus disease and retinal proliferation began to regress. None of the eyes required additional treatment. Follow-up of up to 10 months showed good anatomic outcomes and no evidence of local or systemic adverse events. [<CITE>Ophthalmic Surg Lasers Imaging</CITE> 2007;38:233-237.]</P> <H4>AUTHORS</H4> <P>From the Pediatric Retina Department (ST, FEE, IP, GP), Ophthalmology Service, Hospital Fernando Fonseca, Lisbon; the Surgical Center of Coimbra (AT, IR, AST, RV), Coimbra; the Ophthalmology Department (PF), Centro Hospitalar de Lisboa, Zona Central, Hospital de S. José, Lisbon; Alfredo da Costa Maternity (AV), Lisbon; and the High Commissary for Portuguese Health (MCM), Lisbon, Portugal.</P> <P>Accepted for publication February 26, 2007.</P> <P>Presented at the World ROP Meeting, Vilnius, Lithuania, September 14-16, 2006. Abstract number 015.</P> <P>The authors thank Drs. Stephan Michels and Rike Michels for their support.</P> <p>Address correspondence to Susana Teixeira, MD, Pediatric Retina Department at the Service of Ophthalmology, Hospital Fernando Fonseca, R. João de Freitas Branco nº 21, 6º D, 1500-714 Lisboa, Portugal. E-mail: <a href="mailto:susanateixeira.oft@gmail.com">susanateixeira.oft@gmail.com</a>.</p>

Neonatal Candidemia Exacerbated the Progression of Retinopathy of Prematurity in an Extremely-Low-Birth-Weight Infant with Persistent Tunica Vasculosa Lentis

“…VEGF, a hypoxia-induced cytokine, plays an important role in the normal development of retinal vasculature, in the involution of the HVS and in the development of ROP. 4 In the proliferative phase of ROP, retinal ischemia induces increased levels of VEGF, which leads to retinal NV and persistent TVL. 4 Clinically persistent TVL is often misdiagnosed as iris NV, 10 a condition in which newly formed vessels develop during the iris surface from the pupil margin to the iris root.…”

“…Extremely-low-birth-weight (ELBW) and extreme prematurity are significant risk factors for candidemia 1,2 and retinopathy of prematurity (ROP), 3 in which retinal ischemia induces increased levels of vascular endothelial growth factor (VEGF) leading to retinal neovascularization (NV). 4,5 Studies have shown that candidemia in preterm infants can aggravate the severity of ROP, possibly to the threshold stage requiring laser treatment. 1,[6][7][8] Embryologically, the hyaloid vascular system (HVS) provides the blood supply to the posterior portion of the tunica vasculosa lentis (TVL), a transiently existing network of capillaries that functions to nourish the developing lens.…”

Screening, Treatment and Long-term Observation of Retinopathy of Prematurely Born Children in the Czech Republic

“…Za "pretreshold" stádium se považuje rozsah změn 3. stádia, které nedosahuje prahového stádia. Studie ETROP [16] 10,11,14,18,20,21,24,25,27,[31][32][33]38,41,44,47,50]. Ukazuje se, že léčba anti-VEGF preparáty umožňuje přiměřený vývoj vaskularizace sítnice a je spojena s nižším výskytem refrakčních vad a lepší výslednou zrakovou ostrostí.…”

Current Perspectives in the Management of Retinopathy of Prematurity

“…71,72 The use of the anti-VEGF agent Bevacizumab (Avastin; Genentech, South San Francisco, CA), a recombinant humanized anti-VEGF antibody was reported for use in ROP for the first time in the year 2007. 73,74 However, its use gained popularity after the randomized multicenter BEAT-ROP study which advocated its use in stage 3 ROP in zone 1 or posterior zone 2 ROP. 75 Since then there have been numerous reports of its success in the management of ROP as monotherapy, combination therapy with laser, as rescue therapy after failed laser photocoagulation or as an adjunct prior to vitrectomy.…”