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Hreem Patel, Rebecca Deutsch, Kevin Ferenchak, Jack A Cohen; Outcomes of Treatment for Retinopathy of Prematurity with Intravitreal Bevacizumab at Rush University Medical Center. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4584.
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To investigate the effectiveness and complications of intravitreal bevacizumab as monotherapy for the treatment of Type 1 retinopathy of prematurity (ROP).
A retrospective chart review was performed for eight patients, sixteen eyes with Type 1 ROP at Rush University Medical Center who had intravitreal bevacizumab (IVB) injections from July 2011 to June 2013. Type 1 ROP was defined as zone 1 plus disease, or zone 1, stage 3 with no plus disease, or zone 2, stage 2 or 3 with plus disease. Gestational age, birth weight, sex, race, stage and zone of ROP, presence or absence of plus disease, age at first treatment, initial response to treatment, time until stabilization, additional need for treatment, length of follow up, and final outcome were collected. A total of 0.625mg in 0.025mL of IVB was injected by one single surgeon.
Sixteen eyes of eight patients with Type 1 ROP were treated with IVB; one of which required retreatment 56 days after initial treatment. Mean gestational age was 25 weeks (range, 24 - 27 weeks), mean birth weight was 650 g (range, 430 g - 900 g). The mean gestational age for IVB injection was 37.20 weeks. Mean length of follow up was 99 days (range, 35 - 168 days). Response to treatment within 1 week demonstrated in 87.5% of patients. Time until stabilization was 27.1 days (range 7 - 112 d). ROP regressed in 88.9% of eyes and complete vascularization was seen in 31.25% of eyes throughout the length of the follow up. One eye had an ocular complication with a vitreous hemorrhage. No patients required rescue treatment with laser therapy and no systemic complications were noted by the neonatologist.
IVB injection, used as a monotherapy, is an effective treatment approach in patients with Type 1 ROP. Treatment demonstrated stabilization of the disease within one week of treatment. Only one ocular complication was noted throughout the follow up period. IVB should be considered as a first line treatment for Type 1 ROP.
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