Neurodevelopmental Outcomes in Infants with Retinopathy of Prematurity and Bevacizumab Treatment

Abstract

PurposeThe current study aims to investigate the neurodevelopment of premature infants after intravitreal injections of bevacizumab (IVB) for the treatment of retinopathy of prematurity (ROP) up to the age of 2 years.MethodsThe study design was retrospective observational case series conducted at an institutional referral center. Infants with type 1 ROP were classified into 3 groups: laser only, IVB only, and a combination of IVB and laser treatment. Main Outcome Measures were neurodevelopmental outcomes of the patients after treatment were assessed by Bayley Scales for Infant Development.ResultsSixty-one patients who finished the neurodevelopmental survey were included. No detrimental effects on neurodevelopment were found in IVB group compared with the patients who received laser treatment only. The patients in the IVB + laser group had a higher incidence of significant mental (p = 0.028) and psychomotor (p = 0.002) impairment at 24 months than the patients in the laser group. The odds ratio of having severe psychomotor defects in the IVB + laser group was 5.3 compared with the laser group (p = 0.041). The causal source for the differences that were detected remained unknown due to lack of randomization in the study and accompanying bias in patient selection.ConclusionsTwo years after laser and/or intravitreal injections of bevacizumab for infants with retinopathy of prematurity, no difference on neurodevelopment for those who received only bevacizumab versus only laser treatment were found. Those infants who required rescue therapy with laser or bevacizumab injection after initial, unsuccessful treatment showed some detrimental, neurodevelopmental effects.

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

“…There are studies which investigated the effects of IVB on neurodevelopment. Lien et al [49] investigated the effects of IVB on neurodevelopment at 2 years of age. They did not find any difference between IVB-treated and laser photocoagulation-treated infants.…”

Es bleibt unklar, ob IVB den Blutfluss in der AO und der ACM spezifisch beeinflusst

“…Es ist daher nicht verwunderlich, dass eine andere aktuelle Studie [3] keine Unterschiede fand. Daher ist der Ansatz in der vorliegenden Arbeit interessant.…”

Antivascular endothelial growth factor in the treatment of retinopathy of prematurity

“…However, a significantly higher rate of mental and psychomotor impairment was seen in the combination treatment group as compared with the IVB only group (odds ratio ¼ 5.3). The authors note that it is difficult to determine if the poorer outcomes in the combination group are definitively due to the use of IVB due to lack of randomization and selection bias [28]. In contrast, a recent report by Morin et al evaluated 125 infants at 18 months corrected age at the time of the study and found that those treated with IVB compared with laser for ROP had a higher incidence of severe neurodevelopmental disabilities, such as severe cerebral palsy, hearing aids, and bilateral blindness.…”