title: Unusual adverse choroidal reaction to intravitreal bevacizumab in aggressive posterior retinopathy of prematurity: the Indian Twin Cities ROP screening (ITCROPS) data base report number 7.
abstract: OBJECTIVE
  To describe a case of choroidal ischemia in a neonate after single, bilateral, intravitreal bevacizumab (IVB) injection for severe zone 1 aggressive posterior retinopathy of prematurity (AP-ROP).
  
  
  METHODS
  A six-week-old baby, born at a gestation age of 28 weeks and birth weight of 1.08 kg, presented at a postconceptional age of 34 weeks for ROP screening. On examination, both eyes revealed engorged iris new vessels with poorly dilating pupils. Retinal examination showed media haze, severe zone 1 APROP with confluent new vessels, severe plus disease, and early vitreous condensation at the edge of new vessels for 12 clock hours. The child was treated bilaterally, with single IVB injection before laser. After 16 hours, hypotony and exudative retinal detachment with patches of choroidal whitening suggestive of choroidal ischemia were seen.
  
  
  RESULTS
  The child was treated with topical steroids and cycloplegic drops and exudative retinal detachment resolved on the tenth day. Initial resolution of new vessels showed recurrence after two weeks and was treated with laser photocoagulation. Stable retinopathy status was noted up to six months follow-up.
  
  
  CONCLUSIONS
  Choroidal ischemia secondary to a single IVB injection for the treatment of AP-ROP could be an unusual complication which raises the concern of its use as a monotherapy in neonates.
authors.affiliation: Srimati Kannuri Santhamma Centre for Vitreo Retinal Diseases, L. V. Prasad Eye Institute, Hyderabad Eye Research Foundation , Hyderabad , India.
authors.forename: Jay
authors.initials: J
authors.lastname: Chhablani
authors.forename: Padmaja Kumari
authors.initials: PK
authors.lastname: Rani
authors.forename: Divya
authors.initials: D
authors.lastname: Balakrishnan
authors.forename: Subhadra
authors.initials: S
authors.lastname: Jalali
mesh_terms: D020533:Angiogenesis Inhibitors / Q000009:adverse effects*; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects*; D000068258:Bevacizumab; D002829:Choroid / Q000098:blood supply*; D015862:Choroid Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D019842:Ciliary Arteries / Q000187:drug effects*; D003131:Combined Modality Therapy; D005865:Gestational Age; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D007429:Intraocular Pressure; D058449:Intravitreal Injections; D007511:Ischemia / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D017075:Laser Coagulation; D015814:Ocular Hypotension / Q000139:chemically induced / Q000175:diagnosis; D012178:Retinopathy of Prematurity / Q000188:drug therapy*; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D005938:Glucocorticoids; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab
keywords: APROP; ROP; choroidal ischemia; intravitreal bevacizumab