Intravitreal Bevacizumab and Laser Treatment for Type 1 Retinopathy of Prematurity (ROP): Electroretinographic Responses to Full-Field Stimuli

Abstract

Purpose : Intravitreal injection of the vascular endothelial growth factor (VEGF) antibody bevacizumab is a promising alternative to conventional laser photoablation for the treatment of ROP. We compared the function of neurosensory ROP retinae that had been treated using bevacizumab or using laser.

Methods : Scotopic and photopic electroretinographic (ERG) responses were recorded from both eyes of 19 infants with type 1 zone 1 ROP. One eye was randomized to receive a single intravitreal injection of 0.5 mg bevacizumab and the fellow eye received conventional laser photoablation. The median age at treatment was ~34 weeks post-conception. The median age at first ERG test was 7.7 months post-term. In eight infants, serial ERG testing was performed—three or more tests at ~6 month intervals up to age 3.5 years. The amplitudes of the ERG b-waves were compared to historical normal values for age (Fulton et al., 2003, Documenta Ophthalmologica). For each infant, the difference between the ERG b-wave amplitudes in the bevacizumab and the laser treated eyes were determined and compared to the intraocular differences measured in twelve young adult control subjects.

Results : The amplitudes of ERG responses from the ROP eyes were attenuated compared to the historical values. At the first test, there was no significant difference (Wilcoxon test) between either scotopic or photopic ERG b-wave amplitudes in the bevacizumab and the laser treated eyes. The magnitude of the intraocular difference between bevacizumab and laser treated eyes was similar to that in the controls.

Conclusions : These ERG results offer no evidence that bevacizumab and laser treatment have a differential effect on the function of the neurosensory retina in ROP subjects.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.