Abstract
Purpose :
Vascular endothelial growth factor inhibitors have become an alternative treatment for retinopathy of prematurity (ROP), particularly for disease in zone I. The purpose of this study is to assess the effect of intravitreal bevacizumab on foveal development and macular thickness in infants treated for type 1 retinopathy of prematurity for unilateral disease and compare treated and untreated eyes of the same infant.
Methods :
This is a retrospective case-series of all infants treated with intravitreal bevacizumab (IVB) 0.625mg/0.025ml for unilateral type 1 ROP. Infants in whom spectral domain optical coherence tomography (SD-OCT) imaging of the macula was successfully performed were included. Data on baseline characteristics including sex, gestational age, birth weight, and postmenstrual age (PMA) at the time of treatment were recorded. We compared macular thickness between treated and untreated eyes across a standard early treatment of diabetic retinopathy grid. Foveal structural development in treated and untreated eyes was also compared according to a standard grading system. Univariate analysis of foveal grade was performed using non-parametric tests. The difference in retinal thickness between treated and untreated eyes was examined using a linear mixed effects model. P values < 0.05 were considered significant.
Results :
Seven infants were treated in one eye. All treated eyes had type 1 ROP; stage 3 in zone II with plus disease. All untreated eyes had type 2 ROP that regressed spontaneously. The mean ± SD gestational age of infants was 25.3 ± 0.3 weeks with a birth weight of 776 ± 17.6 grams. Treatment was performed at a mean PMA of 37.2 ± 0.4 weeks. Foveal development was normal in three (43%) treated versus five (71%) untreated eyes (P=0.59). Three patients (43%) demonstrated asymmetric foveal development. In all three, the treated eye’s fovea was more hypoplastic by one grade compared to the untreated eye. Mean central foveal thickness for treated and untreated eyes was 270.1mm ± 19.6 and 253.0mm ± 27.2 respectively (P=0.15).
Conclusions :
In this small case series, there was increased foveal hypoplasia and a thicker fovea with intravitreal bevacizumab treatment compared to no treatment. Further study is needed to determine whether this reflects differences in ROP disease severity or a potential influence of IVB on foveal development.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.