Background Laser photocoagulation (LPC) is considered the standard treatment for retinopathy of prematurity (ROP), but LPC is destructive, causes complications, and does not prevent all vision loss. Recently, bevacizumab (a vascular endothelial growth factor inhibitor) has been used with po-sitive results.
Purpose To evaluate the efficacy and safety of intravitreal bevacizumab vs. LPC in preterm infants with ROP grades 1 to 3+.
Material and methods Ten-month retrospective study that included patients with gestational age of less than 30 weeks diagnosed with ROP grades 1 to 3+, and weight <1,500 g. The subjects received either a single dose of bevacizumab 0.625 mg at three months post-gestational age, or LPC at four-to-eight weeks. The primary efficacy and safety endpoints for both arms of treatment were: complete vascularisation (CV) in both eyes, and absence of adverse events.
Results Twelve patients were included, six for each treatment arm The proportion of females was 50% for the bevacizumab group and 66.6% for the LPC group. Mean gestational age was 25 weeks [23–29] in both groups. Efficacy: CV was achieved in five cases (83.4%) in the bevacizumab arm, and in two patients (33.3%) of those receiving LPC. Safety: no adverse effects were observed in the antiangiogenic treatment arm. In the LPC group, two cases of retinal detachment (inoperable in one case), one of localised reversible haemorrhage, one of retinal fibrosis, and one of laser-related scarring were found.
Conclusion In this cohort, intravitreal bevacizumab was more effective and safer than LPC in the treatment of ROP grades 1–3+. This is consistent with previous published studies, and supports the use of the antiangiogenic over LPC in the treatment of ROP.
References and/or acknowledgements Dr Héctor Mateo
No conflict of interest.
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