The safety and effectiveness of 0.16 mg bevacizumab plus or minus additional laser photocoagulation in the treatment of retinopathy of prematurity

Abstract

Purpose: Retinopathy of prematurity (ROP) is the leading cause of preventable blindness in premature infants. Antivascular endothelial growth factor (anti-VEGF) therapy has been used increasingly in treatment as a pharmacological alternative to laser therapy. In this study, we evaluate the results of low-dose anti-VEGF treatments. Methods: Design: Retrospective--observational study. Infants who had been evaluated for ROP disease between February 2016 and February 2017 were assessed. We retrospectively reviewed the ROP stages, treatment results, and complications. Laser photocoagulation (LPC) and intravitreal bevacizumab (0.16 mg IVB) were used for treatment and fundus fluorescein angiography (FFA) was also performed in some of the cases. Results: IVB was applied to 43 infants. A macular hole was seen in one infant's eye after IVB. LPC was applied to avascular areas in 21 infants. In three patients, persistence of the disease was observed after administration of a low dose of IVB. Additional LFK was performed in these patients. None of the infants who received LPC had any complications. Conclusion: IVB is increasingly becoming the first-line treatment for ROP. For severe ROP, 0.16 mg IVB is effective. Using LPC to treat avascular areas after 70 weeks’ gestational age (GA) may decrease the risk of late recurrence and appears to be a safe treatment to use.

Ranibizumab in retinopathy of prematurity – one‐year follow‐up of ophthalmic outcomes and two‐year follow‐up of neurodevelopmental outcomes from the CARE‐ROP study

“…2012; Chan et al. 2016; Akdogan et al., 2019). It should be noted that the follow‐up period after anti‐VEGF therapy remains a challenging time period to investigators, patients and parents with only limited data existing at present to guide examiners and with increasingly difficult procedures when the infants get older.…”

Contralateral effect of systemic absorption of low dose bevacizumab (Avastin) after unilateral intravitreal injection in severe retinopathy of prematurity (ROP)

“…This dose has been effective in treating ROP and reported in several case series for ROP treatment 5–7. This systemic absorption is at the heart of developmental concerns because of VEGF suppression 1.…”

“…Dose finding studies also suggest that lower doses of bevacizumab (Avastin) may have a reduced suppressive effect on circulating VEGF compared with higher doses and may lead to better peripheral retinal vascularisation 6 7 10…”

Prematürite Retinopatisi Tedavi Sonuçlarımız

“…Retinal vaskülarizasyon tamamlandıktan sonra hayat boyu yıllık muayeneler ile kontrol edilmelidir [18,19]. Tedavi de ise laser fotokoagulasyon altın standart tedavi olup, anti-VEGF ajanlar umut vaad eden tedavi seçeneği olarak araştırılmaktadır [20]. Sonuç olarak; prematüre retinopatisinin yüksek komorbiditesinden dolayı risk faktörlerini barındıran prematür doğumların dikkatlice muayene edilmeleri ve tedaviye ihtiyaç duyulan bebeklerin vakit kaybetmeden tedavilerinin yapılması çok önemlidir.…”