title: [Off-label use of intravitreal bevacizumab for severe retinopathy of prematurity].
abstract: OBJECTIVE
  To examine the quality of evidence and the variability in the off-label use of intravitreal bevacizumab for retinopathy of prematurity (ROP).
  
  
  METHODS
  A wide review of the literature was performed using Pubmed, Medline, and Cochrane database, using the words vascular endothelial growth factor (VEGF), retinopathy of prematurity, treatment and bevacizumab.
  
  
  RESULTS
  Case reports, case series, reviews, one sistematic review and one randomized controlled trial were found on the use of intravitreal bevacizumab in severe ROP, as monotherapy or combined with láser and/or vitrectomy.
  
  
  CONCLUSIONS
  The results shown on the use of intravitreal bevacizumab in ROP stage 3+ in zone I or in aggressive posterior ROP are promising. However, uncertainty remains regarding its maximum tolerable dose in the neonatal group, its ocular and systemic safety profile, or its efficacy and bioactivity in a developing child. This report found no significant differences in the recurrence rates of ROP stage 3+ in zone II in patients treated with intravitreal bevacizumab monotherapy in comparison to láser, although the latter is the best option due to long-term safety and efficacy. The use of intravitreal bevacizumab is not indicated in stages 1 and 2 of ROP as the risk of severe visual loss is low and VEFG is necessary for normal retinal vessel development. On the other hand, the use of intravitreal bevacizumab would be contraindicated in stages 4 and 5 because the retinal detachment is accelerated.
authors.affiliation: Servicio de Oftalmolopediatría, Instituto Oftalmológico Argentino, IOFA, Buenos Aires, Argentina. Electronic address: lauraalba@ymail.com.
authors.forename: L E
authors.initials: LE
authors.lastname: Alba
authors.affiliation: Servicio de Oftalmolopediatría, Instituto Oftalmológico Argentino, IOFA, Buenos Aires, Argentina.
authors.forename: R A
authors.initials: RA
authors.lastname: Zaldua
authors.affiliation: Servicio de Oftalmolopediatría, Instituto Oftalmológico Argentino, IOFA, Buenos Aires, Argentina.
authors.forename: R A
authors.initials: RA
authors.lastname: Masini
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000068258:Bevacizumab / Q000627:therapeutic use*; D006801:Humans; D056687:Off-Label Use; D012178:Retinopathy of Prematurity / Q000188:drug therapy*; D012720:Severity of Illness Index
chemical_list: D020533:Angiogenesis Inhibitors; D000068258:Bevacizumab
keywords: Anti-VEGF; Bevacizumab; Lexemas; Retinopathy of prematurity; Retinopatía del prematuro; Tratamiento; Treatment; VEFG