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Maram Isaac, Kamiar Mireskandari, Nasrin Tehrani; Comparison of outcomes in treatment of Retinopathy of Prematurity: Bevacizumab versus laser.. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4585.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the visual function, structural outcomes and frequency of follow up visits for infants with type I ROP in zone I or posterior zone II treated with intravitreal Bevacizumab (IVB) versus laser.
This is a retrospective chart review. All infants treated for ROP with IVB (0.625mg) and a matched group of infants treated with laser photocoagulation were selected based on a review of RetCam images immediately before treatment between January 2009 and May 2013. All patients were treated for type 1 ROP in zone I or posterior zone II. Infants with a follow up of at least six months post treatment were included. Outcome measures were visual acuity, refractive error and the presence of retinal detachment at 6-12 months of corrected age (CA). Frequency of follow up visits during 6 months post treatment was evaluated.
Twenty five infants were treated with IVB (n=13) or with laser (n=12). There was no statistically significant difference in gestational age or birth weight. At a mean CA of 10.81±1.71 and 11.29±2.58 months (p=0.34), visual acuity (VA) was measurable for 13/23 eyes for IVB and for 17/24 eyes in laser groups respectively. Mean VA was (0.95 ±0.40) and (1.02± 0.31) logMAR, (p=0.34) for IVB and laser groups respectively. Refraction was available for all eyes. Mean spherical equivalent (SE) was (-3.49 ± 6.21) for IVB and (-5.94 ± 4.50) for laser groups (p=0.083), respectively. There were no unfavorable adverse structural outcomes in either group. Infants in IVB group had an average of (14.0 ± 5.0) follow up visits versus (6.0 ± 3.0) in laser group (p =0.0002) in the 6 months post treatment.
Both treatments resulted in good structural outcome. At 6-12 months CA, there was no statistically significant difference in refractive error or VA between two groups, however more frequent follow up was observed in the IVB group. In view of similar structural outcomes between the two groups, frequency of follow up post IVB may need careful reconsideration. Whilst none of the infants in IVB group developed a poor outcome, lack of retinal vascularization for a prolonged period of time is a cause for concern and results in repetitive patient exposure to distressful eye examinations. A careful assessment of extent of vascularization is needed and may help provide further evidence to develop follow up guidelines post IVB.
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