Off-label use of intravitreal bevacizumab (Avastin) for salvage treatment in progressive threshold retinopathy of prematurity.
OBJECTIVE
To report the short term anatomic response of intravitreal bevacizumab (Avastin, Genentech) as salvage treatment in progressive retinopathy of prematurity (ROP) in a small series of patients.


METHODS
The study included five eyes of three patients with progressive ROP despite peripheral laser ablation. Patients received intravitreal injections of bevacizumab (Avastin, Genentech). RetCam (Clarity Medical Systems, Inc., Pleasanton, CA) photography and ultrasonography were used to document effect.


RESULTS
Three patients were transferred to the Bascom Palmer Eye Institute/Jackson Memorial Hospital for management of progressive ROP despite laser therapy at an outside facility. RetCam fundus photography and ultrasonography were used to document all cases. After informed consent was obtained from the parents, the patients received off-label intravitreal bevacizumab as salvage treatment. Repeat intravitreal injections of bevacizumab were utilized in several cases. The ROP stabilized allowing laser supplementation. There was varying development of tractional retinal detachments in several of the eyes but the ROP component quieted in all cases.


CONCLUSIONS
Off-label use of bevacizumab appears to be useful as a salvage treatment for ROP when laser treatment is precluded. It improves dilation, quiets the disease when visibility is difficult, and temporizes the disease until laser can be supplemented.
Lalwani
Geeta A
GA
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Florida, USA.
Berrocal
Audina M
AM
Murray
Timothy G
TG
Buch
Maria
M
Cardone
Scott
S
Hess
Ditte
D
Johnson
Rose A
RA
Puliafito
Carmen A
CA
D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D018450:Disease Progression; D004348:Drug Labeling; D006801:Humans; D007231:Infant, Newborn; D053685:Laser Therapy; D012178:Retinopathy of Prematurity / Q000188:drug therapy*; D016879:Salvage Therapy; D017211:Treatment Failure
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab