Intravitreal bevacizumab in combination with laser therapy for the treatment of severe retinopathy of prematurity (ROP) associated with vitreous or retinal hemorrhage.
OBJECTIVE
To evaluate outcomes of intravitreal injection of bevacizumab for the treatment of severe retinopathy of prematurity (ROP) associated with vitreous or retinal hemorrhages (VH or RH).


METHODS
This is a prospective interventional case-series. Fourteen eyes of eight premature infants with severe ROP associated with vitreous or retinal hemorrhage were consecutively included. In eight eyes, VH and/or RH precluding complete laser ablation developed at the time of laser treatment. In six eyes, VH developed early after laser ablation. All participants underwent intravitreal injection of 0.625 mg (0.025 ml) bevacizumab immediately after diagnosis of VH or RH. Follow-up examinations were performed at days 1, 3, 7, and 14, and 1, 2 and 3 months after injection. Main outcome measure was the absence of unfavorable structural outcomes.


RESULTS
Mean gestational age was 27.6 weeks (range, 26-29 weeks) and mean birth weight was 1047 g (range, 780-1500 g). Mean gestational age at the time of injection was 35.4 weeks (range, 32-38 weeks). In all eyes, plus disease disappeared completely within 2 weeks and VH and/or RH was absorbed at last follow-up. None of the eyes developed unfavorable structural outcomes. No eyes needed additional injection or laser treatment. No major systemic or ocular complications were observed.


CONCLUSIONS
In this small series of patients, intravitreal injection of bevacizumab was effective for treatment of severe retinopathy of prematurity associated with vitreous or retinal hemorrhage.
Nazari
Hossein
H
Eye research center, Iran University of Medical Sciences, Rassoul Akram hospital, Sattarkhan-Niayesh Street, Tehran, 14455-364, Iran. h01nazari@yahoo.com
Modarres
Mehdi
M
Parvaresh
Mohammad Mehdi
MM
Ghasemi Falavarjani
Khalil
K
D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D003131:Combined Modality Therapy; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D058449:Intravitreal Injections; D017075:Laser Coagulation; D008297:Male; D011446:Prospective Studies; D012166:Retinal Hemorrhage / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D012178:Retinopathy of Prematurity / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*; D014823:Vitreous Hemorrhage / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab