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Yuta Saito, Isamu Ito, Toshihiko Ueda, Michiko Matsubara, Eiichi Nishimura, Haruo Takahashi; Effects of Lower Dosage of Intravitreal Bevacizumab in Retinopathy of Prematurity. Invest. Ophthalmol. Vis. Sci. 2013;54(15):591. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the effects of lower dosage of intravitreal injections of bevacizumab (IVB) in retinopathy of prematurity (ROP).
There were fourteen eyes of 7 patients receiving IVB (0.25mg/eye) for treatment of ROP from April 2011 to June 2012 at Showa University. This retrospective case series included the patients who were followed up at least 5 months after IVB.
Ten eyes of 5 patients (4 male and 1 female) were included in this study. 2 patients were excluded from the study because of a follow-up time of less than 1 month. Mean gestational age and birth weight were 24.6 (range: 22-26) weeks and 770.2 grams (range: 505-1055). There were eight eyes of 4 patients with stage 3 ROP treated by conventional laser, and two eyes of 1 patient with aggressive posterior ROP (AP-ROP) without laser treatment. All of the eyes received only a single injection of IVB. The mean injection time was 37.2 (range: 34-39) weeks. No complications such as cataract or endophthalmitis occurred. Of eight eyes with stage 3 ROP, six eyes (4 patients) regressed after IVB. Two eyes (2 patients) were treated with vitrectomy after IVB because of progressive tractional retinal detachment. The retina of one eye failed to reattach after vitrectomy surgeries. AP-ROP was regressed after IVB and subsequent conventional laser treatment.
IVB was performed as a salvage therapy in this study. Lower dosage of IVB seems effective to regress ROP. However, it also increased fibrotic traction in some eyes. In the BEAT-ROP study, a dosage of 0.625 mg is recommended as a monotherapy. Whereas intravitreal injected bevacizumab can escape to systemic circulation. Thus, usage of lower dosage of IVB for ROP in combination with conventional laser therapy appears to be safe until the optimal dosage will be established.
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