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S. Kusaka, C. Shima, T. Wakabayashi, T. Sato, H. Shimojyo; Efficacy of Intraocular Administration of Bevacizumab on Severe Retinopathy of Prematurity. Invest. Ophthalmol. Vis. Sci. 2007;48(13):3204.
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To evaluate the efficacy of intravitreal bevacizumab (Avastin®) in the treatment of severe retinopathy of prematurity (ROP).
Retrospective review of consecutive case series of 6 eyes of 4 patients with zone I ROP (stage 3: 1 eye, stage 4A: 5 eyes) that had been responded poorly to conventional retinal photocoagulation therapy. Birth weight and gestational age ranged from 24 to 26 weeks (mean 25 weeks) and 700 to 962 gram (mean 842 gram), respectively. Injection of bevacizumab (0.75mg) was performed as a sole treatment in 4 eyes, or at the end of vitrectomy in 2 eyes. Before and approximately 1 week after the injection, fluorescein angiography (FA) and fundus examination were performed.
All eyes showed decrease in fluorescein leakage from neovascularization after bevacizumab injection. Vascular dilatation and tortuosity that had been evident in 4 eyes before the treatment improved after the treatment. However, two eyes with stage 3 and 4A ROP progressed to stage 4A and 4B ROP after the treatment, respectively, and required lens-sparing vitrectomy. No local or systemic adverse events were observed during the follow-up period of 1 to 2 months.
Although further study including long-term careful follow-up with more patients is necessary to establish the safety and efficacy of intravitreal bevacizumab injection, it appears to provide alternative in the treatment of severe ROP that is refractory to conventional laser treatment.
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