Abstract
Purpose :
To report on the long-term structural, visual and refractive outcomes of type 1 ROP treated with intravitreal bevacizumab injection (IVB).
Methods :
We retrospectively reviewed charts of all infants treated with 0.625 mg IVB between January 2010 and December 2016. Infants with a minimum follow up of three years ± 6 months were included. Primary outcome measure was structural outcome as defined by ETROP criteria. Secondary outcomes were monocular visual acuity (VA) reported in logMAR and refractive errors reported in spherical equivalent (SE). Data on demographics and ROP parameters were collected.
Results :
A total of 60 infants (108 eyes) were treated. Forty-three infants (76 eyes) met inclusion criteria and had type 1 ROP in zone I (20 eyes; 26%) or zone II (56 eyes; 74%). Nine infants (20%) were treated in one eye only. Mean gestational age was 25.02±1.37 (range 23.3-29.7) weeks, birth weight 725±191 (range 420-1520) grams, and post-menstrual age at treatment 36.8±2.2 (range 32.8-42) weeks. All eyes had favourable structural outcome with no recurrence requiring treatment. Mean monocular VA was 0.3±0.3 logMAR (median 0.3, range 0.0 to 1.3; n=64/76 eyes) at a mean of 5.0±1.5 years (median 5.1, range 2.5-7.5) post treatment. Favourable visual outcomes were achieved in 95% (61/64) of the eyes in infants who complied with visual acuity testing. Mean refractive error was -2.4±5.4 (median -0.1, range -17.0 to +8.3 D , n=76/76 eyes) at a mean 5.1±1.6 years (median 5.0, range 2.2-9.0) post treatment. Prevalence of emmetropia (>-1.0 to ≤1 D) was 47.4% (36/76 eyes) , low myopia (≥1.0 to <5 D) was 14.5% (11/76 eyes), high myopia (≥5 to <8 D) was 9.2 % (7/76 eyes), very high myopia (≥ 8.0 D) 17.1% (13/76 eyes), low hyperopia (>1 to ≤4 D) was 9.2% (7/76 eyes), and high hyperopia >4 D was 2.6% (2/76 eyes).
Conclusions :
In this cohort of infants, at an extended mean follow up of 5 years, all eyes had favourable structural outcome with no recurrence requiring treatment. Ninety-five percent of testable eyes had favourable visual outcome. Emmetropia occurred in almost half the eyes. Higher degrees of myopia occurred in comparison to the BEAT-ROP refractive outcomes. Previously reported favorable 1 year outcomes after IVB monotherapy are also seen in the long term. Future studies to further evaluate visual function including visual field testing are planned.
This is a 2020 ARVO Annual Meeting abstract.