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Nasrin Najm Tehrani, Maram Isaac, Kamiar Mireskandari; Type 1 retinopathy of prematurity: time to regressionfollowing treatment with intravitreal bevacizumab. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):955.
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© ARVO (1962-2015); The Authors (2016-present)
Anti Vascular endothelial growth factors (VEGF) are increasingly used in the management of type1 retinopathy of prematurity (ROP). The aim of this study is to describe regression patterns following monotherapy with intravitreal bevacizumab (IVB) for type 1 ROP in zone I or zone II posterior.
This is a retrospective chart review of all infants with ROP treated at our institution with 0.625mg IVB between January 2010 and April 2014. All infants with minimum of 72 weeks of postmenstrual age (PMA) at last follow up were included. The primary outcome of the study was time to involution of type 1 ROP in the first 3 months post treatment. Secondary outcome was structural outcome at last follow up. Involution of ROP was defined as regression of disease severity by at least one stage and absence of plus disease. Data was collected on demographics, retinal examination results at each visit and development of recurrence and/or retinal detachment (RD). Findings were described in cumulative frequency tables.
Seventeen infants (28 eyes) were included. The average follow up period post treatment was 88.4±45.2 weeks (range 35.6-220.4). The mean gestational age was 25.2±1.3 weeks (range 23.3-27.6) and the mean birth weight was 727±117 grams (range 540-920).The mean PMA at treatment was 37.4±1.8 weeks (range 35-41.7) and the mean PMA at last follow up was 132.2±47.6 weeks (median 124.2, range 76.1-272.3). Cumulative frequency of regression of plus disease was seen in 71%, 88%, and 100% by days 3, 5, and 8 respectively. Regression of both stage 3 and plus ROP was observed in 29%, 82%, 88%, and 100% by weeks 1, 2, 3, and 4 respectively post treatment. None developed a recurrence or RD at last follow up.
Regression of plus disease occurred earlier than regression of stage 3 and was seen in all infants by eight days. Stage 3 regressed completely in all infants by four weeks. We did not observe any unfavorable structural outcomes at last follow up.<br /> Based on this data, routine laser treatment soon after bevacizumab injection may not be indicated. Our experience suggests that disease recurrence and retinal detachment are not common. None of our patients required further treatment.
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