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Margaret Littlejohn, Lingkun Kong, Ann Demney, Robert G. Voigt, Sonia A. Monteiro; Long-Term Growth and Systemic Outcomes in Laser and Bevacizumab-Treated Infants with Retinopathy of Prematurity. Invest. Ophthalmol. Vis. Sci. 2018;59(9):3764. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Recent usage of intravitreal bevacizumab (IVB) to treat retinopathy of prematurity (ROP) has led to questions regarding the systemic absorption of bevacizumab and its potential long-term side effects. We performed a prospective, observational clinical study to test the hypothesis that IVB-treated infants have the similar long-term growth and systemic outcomes compared to laser-treated infants.
Total of 67 infants were who were treated with IVB injection (N=47) or laser (N=20) from 2010 to 2014 were enrolled. The neurodevelopmental outcome measurements include body weight (BW), height and head circumference (HC) at age 1 and 3; neurodevelopmental quotient (DQ) at age 1 and 3. Systemic multi-organ functional outcomes include: aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase, and gamma-glutamyl transferase (GGT), conjugated and unconjugated bilirubin, and albumin levels for liver; blood urea nitrogen (BUN) and creatinine levels for kidney at 2 months post-teatment and 1 and 3 years of age. Two-tailed Student’s t-tests were used to compare the group means of the IVB-treated and laser-treated groups.
There was global developmental delay in both groups. Patients in both groups showed progress over time, but the changes were not significant, p=0.1 to 0.7. There were no significant differences in neurodevelopmental sub-domains (gross motor, visual-motor problem solving, and language DQ), body weight, height and HC between the two groups at age 1 and 3, p=0.3. Infants treated with IVB had lower AST levels (p=.002) at 2 months post treatment as well as lower albumin levels (p=.034) at 4 weeks post treatment. Other hepatic lab values showed non-significant differences. IVB treated infants showed lower creatinine levels (p=.013) at 2 months post treatment. Other renal lab values showed non-significant differences in groups. IVB treated infants demonstrated significantly lower blood glucose (p=.041) at 2 years of age. Other blood glucose readings showed non-significant differences between groups. No significant differences between IVB and laser treated infants were demonstrated in hemoglobin, hematocrit, or platelet counts.
Our results indicate that there were differences in liver, kidney and blood glucose lab tests between IVB and laser treated infants. The clinical significance among these changes needs to be investigated.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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