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Nasrin Najm Tehrani, Maram Isaac, Kamiar Mireskandari; Bilateral Retinal Vascularization after Unilateral Bevacizumab for Type 1 Retinopathy of Prematurity. Invest. Ophthalmol. Vis. Sci. 2016;57(12):6275.
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© ARVO (1962-2015); The Authors (2016-present)
To address the question of whether a single injection of intravitreal bevacizumab (IVB) for type 1 retinopathy of prematurity results in abnormal retinal vascularization, we compared fundus flourescein angiography (FFA) between treated and untreated eyes in unilaterally treated infants.
This is a retrospective chart review of all infants treated with IVB in one eye from March 2012 - April 2014. Treatment was performed and structural outcomes defined according to the Early Treatment for Retinopathy of Prematurity study criteria. We measured the extent of temporal vascularization before and after treatment. A linear measurement in disc diameter (dd) was taken from the center of the temporal edge of the optic disc extending through the fovea to the border of vascular-avascular retina. Measurements were performed using ImageJ software with line analysis tools. We also collected data on the presence or absence of leakage on FFA.
Five infants were included. The fellow eyes did not meet treatment criteria at any time. All treated eyes responded to a single injection of 0.625 mg IVB and showed regression of disease activity. None had a recurrence or required further treatment. Vascularization extent between treated and untreated eyes was within 2.0 dd on FFA performed at a mean of 10.2±2.9 months post treatment. In two patients, there was leakage of flourescein on images performed at 12 and 14.5 months post treatment in treated and untreated eyes at the vascular-avascular margin in the absence of neovascularization. All treated eyes vascularized to ora serrata nasally and none developed unfavorable structural outcomes at a mean follow up of 28.9±10.1 months. All but one untreated eye vascularized into zone III.
In this cohort, vascular growth was comparable between treated and untreated eyes of the same infant. Systemic absorption did not appear to impede retinal vascularization in the untreated eyes. Leakage from advancing retinal vasculature in the absence of neovascularization may be seen in both treated and untreated eyes without long-term unfavorable outcomes. These vascular abnormalities may be related to prematurity rather than treatment with bevacizumab.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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