Intravitreal Bevacizumab for Retinopathy of Prematurity

Background: To evaluate the therapeutic effect of a single intravitreal injection of bevacizumab for treatment of threshold retinopathy in retinopathy of prematurity (ROP). Methods: The retrospective study consisted of all infants who developed threshold ROP in fundus zone I or zone II and who consecutively received an intravitreal injection of bevacizumab (0.375 mg, 0.03 mL) in local anesthesia. Results: Twelve infants (23 eyes) were included into the study. The mean birth weight was 625 +/- 187 g (mean +/- standard deviation; range: 450-810 g), mean gestational age was 25.1 +/- 1.4 weeks (range: 24.0-28.7 weeks), mean age at the time of intervention was 38.1 +/- 3.7 gestational weeks (range: 32.1-45.6 weeks), and mean follow-up was 30.4 +/- 25.9 weeks. Three children (6 eyes) showed aggressive posterior ROP. After the injection, all eyes showed a regression of plus disease within 2-6 days, a decrease in pupillary rigidity, a resolution of any tunica vasculosa lentis, and a complete regression of the retinal neovascularization within 2-3 weeks. In none of the children a second intravitreal injection of bevacizumab was performed. Conclusions: A single intravitreal bevacizumab injection of 0.375 mg in 0.03 mL appears to be potentially helpful for the therapy of threshold ROP avoiding side effects of conventional retinal laser coagulation such as irreversible retinal scarring. Long-term effects and side effects may be assessed in future prospective randomized trials.