Neurodevelopmental outcomes in infants treated with intravitreal bevacizumab versus laser

Raghuram, Kamini; Isaac, Maram; Yang, Junmin; AlAli, Alaa; Mireskandari, Kamiar; Ly, Linh; Kelly, Edmond; Banihani, Rudaina; Shah, Prakesh S.; Tehrani, Nasrin

doi:10.1038/s41372-019-0420-z

Cited by 32 publications

(46 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In spite of an increasing number of ELBW infants exposed to IVB, the risk of adverse ND outcome related to IVB therapy remains unclear. This study findings support a growing number of published reports 9,11,13 which indicate that the use of IVB in ELBW infants is safe. However, its safety is still not widely accepted because all of these favorable studies had a retrospective design and small sample sizes.…”

Section: Discussionsupporting

confidence: 91%

“…These studies included infants who were diagnosed and treated at multiple and various medical centers. In contrast, studies that included infants from one 11,21 or two study centers 13 found no association between adverse outcome and treatment with IVB. Multicenter studies are beneficial because they capture a large patient population and allow better generalization than single-center studies.…”

Section: Discussionmentioning

confidence: 90%

“…The fact that IVB can seep into the systemic circulation and may potentially affect brain development of the preterm infant is concerning. 7,8 Several retrospective studies [9][10][11][12][13] have assessed the risk of neurodevelopmental impairment (NDI) related to IVB therapy in preterm infants but reported conflicting results. In addition, the population of periviable infants who are at highest risk for posteriorly located ROP disease, and who could be the most vulnerable subjects for the adverse effects of anti-VEGF therapy, was adequately represented in only one study that showed higher death and developmental impairment in the bevacizumab-treated group.…”

mentioning

confidence: 99%

“…3 Recently, Raghuram et al found that 20% of type 1 ROP were located posteriorly in zone 1. 13 In our neonatal intensive care unit (NICU), we have been treating high-risk prethreshold (type-1) ROP with IVB since 2011. We assessed the safety of IVB therapy in our ELBW infants who are predominantly periviable.…”

mentioning

confidence: 99%

See 3 more Smart Citations

Bevacizumab for Retinopathy of Prematurity: 2-Year Neurodevelopmental Follow-up

et al. 2020

View full text Add to dashboard Cite

Objective This study aimed to determine whether infants who were treated with intravitreal bevacizumab (IVB) for retinopathy of prematurity (ROP) were at higher risk of death or neurodevelopmental impairment (NDI) when compared with infants who were not treated with IVB (Laser only). Study Design This retrospective study included 146 infants born from 2009 through 2016 with a birth weight (BW) <1,000 g, gestational age <27 weeks, and required ROP therapy. Death and NDI rates were assessed at 18 to 24 months' corrected age. Results Rates of death or severe NDI were 62 and 53% in the IVB (n = 61) and Laser only (n = 85) groups, respectively. This difference was not statistically different despite sample selection bias in treating growth-restricted infants with IVB, BW (median [IQR]) was 481 (420–583) versus 547 (473–640) g in IVB and Laser only groups, respectively, p = 0.003. The adjusted odds ratio and 95% confidence interval of death or severe NDI was 0.86 (0.33–2.20). Conclusion Bevacizumab therapy for ROP did not affect survival and neurodevelopment of extremely preterm infants. Key Points

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 90%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Bevacizumab for Retinopathy of Prematurity: 2-Year Neurodevelopmental Follow-up

et al. 2020

View full text Add to dashboard Cite

show abstract

“…These animal findings were substantiated in humans when use of Avastin, a humanized anti-VEGF monoclonal antibody that had proven effective for pathological retinal neovascularization in adults, was first shown to be efficacious in treatment of ROP [35][36][37]. However, there is concern for potential adverse local and systemic effects of intraocular anti-VEGF treatments [38][39][40][41][42][43]. VEGF is now recognized as an important trophic factor for a variety of retinal cell types including retinal neurons, RPE, and glia [44,45].…”

Section: Anti-vegf Treatment For Ropmentioning

confidence: 92%

Current evidence and outcomes for retinopathy of prematurity prevention: insight into novel maternal and placental contributions

Carroll

Owen

2020

Exploration of Medicine

View full text Add to dashboard Cite

Retinopathy of prematurity (ROP) is a blinding morbidity of preterm infants, which represents a significant clinical problem, accounting for up to 40% of all childhood blindness. ROP displays a range of severity, though even mild disease may result in life-long visual impairment. This is complicated by the fact that our current treatments have significant ocular and potentially systemic effects. Therefore, disease prevention is desperately needed to mitigate the life-long deleterious effects of ROP for preterm infants. Although ROP demonstrates a delayed onset of retinal disease following preterm birth, representing a potential window for prevention, we have been unable to sufficiently alter the natural disease course and meaningfully prevent ROP. Prevention therapeutics requires knowledge of early ROP molecular changes and risk, occurring prior to clinical retinal disease. While we still have an incomplete understanding of these disease mechanisms, emerging data integrating contributions of maternal/placental pathobiology with ROP are poised to inform novel approaches to prevention. Herein, we review the molecular basis for current prevention strategies and the clinical outcomes of these interventions. We also discuss how insights into early ROP pathophysiology may be gained by a better understanding of maternal and placental factors playing a role in preterm birth.

show abstract

Comparison of adverse events between intravitreal anti-VEGF and laser photocoagulation for treatment-requiring retinopathy of prematurity: a systematic review

et al. 2022

View full text Add to dashboard Cite

Purpose To synthesize existing evidence on adverse events, complications, and unfavorable outcomes of current treatment modalities for treatment-requiring retinopathy of prematurity (TR-ROP). Methods PubMed, Cochrane Central Register of Controlled Trials, Scopus, EMBASE, Trip Database, and the gray literature available were searched. Randomized Clinical Trials and observational studies comparing the adverse events of intravitreal anti-VEGF injections (bevacizumab, ranibizumab, aflibercept, pegaptanib, conbercept) and laser photocoagulation (LPC) as treatment modalities for infants with TR-ROP were included. The main outcomes compared between the two treatment modalities were: 1. Refractive Errors and Biometry Parameters, 2. Adverse events, complications, and unfavorable outcomes, 3. Disease Recurrence/Disease Regression/Need for retreatment, 4. Neurodevelopmental Outcomes. Results Higher quality studies concluded that LPC leads to greater rates of myopia than intravitreal anti-VEGF treatment while the rate of adverse events and of unfavorable neurodevelopmental outcomes is similar. However, there was controversy among the included studies concerning the rate of ROP recurrence between intravitreal anti-VEGF injections and LPC. Conclusion There is need for future primary studies assessing the adverse events of intravitreal anti-VEGF injections compared with LPC as treatment modalities for infants with TR-ROP.

show abstract

Neurodevelopmental outcomes in infants treated with intravitreal bevacizumab versus laser

Cited by 32 publications

References 33 publications

Bevacizumab for Retinopathy of Prematurity: 2-Year Neurodevelopmental Follow-up

Bevacizumab for Retinopathy of Prematurity: 2-Year Neurodevelopmental Follow-up

Current evidence and outcomes for retinopathy of prematurity prevention: insight into novel maternal and placental contributions

Comparison of adverse events between intravitreal anti-VEGF and laser photocoagulation for treatment-requiring retinopathy of prematurity: a systematic review

Contact Info

Product

Resources

About