June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Pilot Study of Retinal Vessel Outgrowth Following Conventional Versus Low-Dose Bevacizumab for Retinopathy of Prematurity
Author Affiliations & Notes
  • David Sutter
    Midwestern University Chicago College of Osteopathic Medicine, Downers Grove, Illinois, United States
  • Talita Toledo Lima
    Ophthalmology, Centro Brasileiro de Cirurgia de Olhos, Goiania, Goiás, Brazil
  • Noreen Clarke
    Ophthalmology, Children's Hospital Los Angeles Department of Pediatrics, Los Angeles, California, United States
  • Kathleen Anulao
    Ophthalmology, Children's Hospital Los Angeles Department of Pediatrics, Los Angeles, California, United States
  • Thomas Lee
    Ophthalmology, Children's Hospital Los Angeles Department of Pediatrics, Los Angeles, California, United States
  • Aaron Nagiel
    Ophthalmology, Children's Hospital Los Angeles Department of Pediatrics, Los Angeles, California, United States
  • Footnotes
    Commercial Relationships   David Sutter None; Talita Lima None; Noreen Clarke None; Kathleen Anulao None; Thomas Lee None; Aaron Nagiel None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 4172 – F0232. doi:
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    • Get Citation

      David Sutter, Talita Toledo Lima, Noreen Clarke, Kathleen Anulao, Thomas Lee, Aaron Nagiel; Pilot Study of Retinal Vessel Outgrowth Following Conventional Versus Low-Dose Bevacizumab for Retinopathy of Prematurity. Invest. Ophthalmol. Vis. Sci. 2022;63(7):4172 – F0232.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Recent studies have demonstrated that very low doses of bevacizumab can be used to treat Type I prethreshold retinopathy of prematurity (ROP). We hypothesized that lower doses of intravitreal bevacizumab may promote the normal outgrowth of retinal vessels following injection. The goal of this pilot study is to compare the rate of vessel outgrowth after conventional dose (0.625 mg) and low-dose (0.125 mg) treatment.

Methods : This was an IRB-approved retrospective chart review of patients treated with intravitreal bevacizumab before and after the institution switched to low-dose bevacizumab in September 2019. All eyes had Retcam color and fluorescein angiography (FA) taken at the time of intravitreal bevacizumab injection and at subsequent laser photocoagulation. Gestational age at birth, birthweight, corrected age at injection, and weeks between injection and laser were tabulated. Six eyes of six infants who met these criteria were identified: 3 eyes treated at low dose and 3 eyes treated with conventional dose. Photos were analyzed using MATLAB R2021a. The average distance from optic disc to ridge were calculated using 15 vectors from the nerve to the temporal ridge encompassing one clock hour.

Results : Baseline parameters including birthweight, gestational age at birth, and zone/stage of ROP were comparable between the two groups. Optic nerve to ridge distance at time of injection and laser were used to calculate vessel outgrowth (pixels) and rate of vessel outgrowth (pixels/week) in 6 eyes of 6 patients. Mean vessel outgrowth was 153 pixels for conventional and 260 pixels for low-dose eyes (one-tailed t-test; p < 0.015). When corrected for number of weeks since injection, the rate of vessel outgrowth was 32 pixels/week and 30 pixels/week for conventional and low-dose eyes, respectively (p > 0.64). The mean interval between injection and laser was 5 weeks for conventional and 9 weeks for low dose eyes (p > 0.07).

Conclusions : Low-dose treated eyes had significantly greater vessel outgrowth, but this could be explained by a longer interval between injection and laser treatment in the low-dose group. This pilot study warrants further quantitative analysis of the potential benefits of low-dose bevacizumab treatment in a larger cohort of patients.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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