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Brian Savoie, Adnan Mallick, Ronni M Lieberman; Outcomes In Type I Retinopathy of Prematurity Treated with Intravitreal Bevacizumab. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5538.
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© ARVO (1962-2015); The Authors (2016-present)
To determine efficacy and complications associated with the use of intravitreal bevacizumab (IVB) for treatment of type I Retinopathy of Prematurity (ROP).
In this retrospective study, 19 eyes of 11 patients with type I ROP treated with IVB between 2012-2016 were reviewed. Three eyes of two patients were excluded due to inadequate follow-up. All patients were followed for at least 6 months. Records were reviewed for birth weight, gender, gestational age, chronological age at time of treatment, ROP classification, and duration of follow up. Outcome measurements were dilated fundus exam (DFE) at last visit, recurrence of disease, refractive error, strabismus and developmental delay. Dilated fundus examination was recorded as: attached with no macular dragging, attached with macular dragging, detached stage IV or detached stage V. Recurrences were defined as recurrent plus disease requiring treatment or recurrent neovascularization. Time to recurrence, treatment and results were recorded. The incidence of refractive error requiring spectacle correction, strabismus and neuro-developmental delay were also tabulated.
Of nine patients, the average birth-weight was 776.5g (range 590-890), gestational age was 25.6 weeks (range 23-28), and chronological age at time of treatment was 36.8 weeks (range 32-45). Four patients (45%) were male. 14 eyes (88%) were injected for type I ROP; two eyes (13%) for stage III, zone II, pre-plus disease with neovascularization of the iris. Average duration of follow up was 18.4 months. On follow up, all 16 eyes (100%) remained attached with no macular dragging. No eye showed acute contraction of proliferative membrane after injection. 15 eyes (94%) reached maturity without further complication. Recurrence occurred in one eye requiring retreatment. After re-treatment, there was regression of disease without further complication. No patient developed refractive error requiring correction or manifest strabismus. Developmental delay was found in five patients.
Findings suggest that IVB is effective in treating type I ROP. No evidence of macular dragging was found, as has been shown with traditional therapy. No patient developed refractive error or strabismus requiring treatment. Developmental delay occurred in five patients, however the impact of IVB on development remains ill defined. Further trials are needed to assess long-term safety and complications.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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