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Sailaja (Sailu) Bondalapati, Jan Ulrich, Michelle T Cabrera; The Effect of Intravitreal Bevacizumab on Cystoid Macular Edema (CME) in Retinopathy of Prematurity (ROP) as Detected by Handheld Spectral Domain Optical Coherence Tomography (SDOCT). Invest. Ophthalmol. Vis. Sci. 2014;55(13):5933.
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© ARVO (1962-2015); The Authors (2016-present)
To describe characteristics of CME in infants screened for ROP including response to intravitreal bevacizumab for type 1 ROP.
Fifty infants undergoing routine screening for ROP at the University of North Carolina Newborn Critical Care Center underwent imaging with the Envisu R2300 II handheld SDOCT (Bioptigen, Inc, Morrisville, NC) in this prospective observational study. Images were analyzed for presence of CME using Bioptigen InVivoVue 2.0 software.
Fifty premature infants (52% male, median gestational age 28 weeks, range 23-32; median birth weight 965g, range 506-1695; median postmenstrual age at imaging 36 weeks, range 31-52) were imaged with SDOCT. Of the 50 infants, 11 (22%) had CME on SDOCT, of which 8/11 (73%) had ROP. CME was associated with type 1 ROP (p=0.0002), younger gestational age (P=0.0087), higher postmenstrual age at imaging (p=0.0009), and male sex (p=0.0379), however, no significant associations were found for race, birth weight, or ROP zone, stage, or plus status by itself. There was a trend towards significance for stage of ROP (p=0.09). All five infants (100%) requiring intravitreal bevacizumab injections for type 1 ROP had CME on OCT compared to 13% (6/45) of infants not requiring treatment (p=0.0002). CME resolved following bevacizumab injections in two of the five infants, at one and two weeks post-treatment, respectively. CME in a third infant remained stable one week post-treatment. No subsequent imaging was performed due to infant instability. The remaining two infants were recruited after receiving bevacizumab injections and were found to have CME at the first imaging sessions, which was at eight and 16 weeks post-treatment, respectively. Both infants were discharged soon after and therefore CME status could not be reassessed.
CME was associated with type 1 ROP, younger gestational age, higher postmenstrual age at imaging, and male sex. This study suggests that intravitreal bevacizumab for type 1 ROP has variable effect on CME in these cases. Larger studies with longer follow-up are needed to determine the long-term effect of intravitreal bevacizumab on macular edema of prematurity and associated visual outcomes.
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