title: Serial evaluation of retinal vascular changes in infants treated with intravitreal bevacizumab for aggressive posterior retinopathy of prematurity in zone I.
abstract: OBJECTIVE
  To evaluate the serial changes in retinal vasculature in infants treated with intravitreal bevacizumab (IVB) for aggressive posterior retinopathy of prematurity (APROP) in zone I.
  
  
  METHODS
  Retrospective analysis of serial changes in retinal vasculature after IVB in the seven eyes of four babies with APROP in zone I.
  
  
  RESULTS
  The initial regression, following IVB, was dramatic with reduction in vessel caliber and marked thinning and invisibility of the bridging shunts. Resurgent vascular development was very slow radially though there was continued abnormal vascular growth circumferentially. Common findings in all eyes were tangled vasculature and fine saw-toothed shunts. The variable findings were (1) new closely packed multilayered bridging shunts, long arching mature looking vessels, and finally a ridge at the periphery (n=3 eyes) at 52 weeks of postmenstrual age (PMA); (2) status quo at the stage of saw-toothed shunt and ridge in both eyes for a long time (n=2 eyes); and (3) multiple retinal hemorrhages within the vascularized retina and thick preretinal hemorrhage overlying the saw-toothed shunts and ridge that persisted for another 3 weeks and regressed 2 weeks after laser (n=1). The eyes that received bevacizumab alone (3) did not show any abnormal vascularization at 56 weeks of PMA or beyond.
  
  
  CONCLUSIONS
  The retinal vascularization following IVB was different than normal in terms of its time, speed, and morphology; few of these changes are first to be reported in the literature (Medline search) and warrants further studies.
authors.affiliation: Miriam Hyman Children Eye Care Center, LV Prasad Eye Institute, Bhubaneswar, India.
authors.forename: T R
authors.initials: TR
authors.lastname: Padhi
authors.affiliation: Kanuri Santhamma Center for Vitreo Retinal Disease, LV Prasad Eye Institute, Banjara Hills, Hyderabad, India.
authors.forename: T
authors.initials: T
authors.lastname: Das
authors.affiliation: Miriam Hyman Children Eye Care Center, LV Prasad Eye Institute, Bhubaneswar, India.
authors.forename: S
authors.initials: S
authors.lastname: Rath
authors.affiliation: Infosys Pediatric Center, Capital Hospital, Bhubaneswar, India.
authors.forename: L
authors.initials: L
authors.lastname: Pradhan
authors.affiliation: Miriam Hyman Children Eye Care Center, LV Prasad Eye Institute, Bhubaneswar, India.
authors.forename: S
authors.initials: S
authors.lastname: Sutar
authors.affiliation: Miriam Hyman Children Eye Care Center, LV Prasad Eye Institute, Bhubaneswar, India.
authors.forename: K G
authors.initials: KG
authors.lastname: Panda
authors.affiliation: Miriam Hyman Children Eye Care Center, LV Prasad Eye Institute, Bhubaneswar, India.
authors.forename: R
authors.initials: R
authors.lastname: Modi
authors.affiliation: Kanuri Santhamma Center for Vitreo Retinal Disease, LV Prasad Eye Institute, Banjara Hills, Hyderabad, India.
authors.forename: S
authors.initials: S
authors.lastname: Jalali
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000068258:Bevacizumab / Q000627:therapeutic use*; D001724:Birth Weight; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D058449:Intravitreal Injections; D015861:Retinal Neovascularization / Q000473:pathology*; D012171:Retinal Vessels / Q000473:pathology*; D012178:Retinopathy of Prematurity / Q000145:classification / Q000188:drug therapy* / Q000503:physiopathology; D012189:Retrospective Studies; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors
chemical_list: D020533:Angiogenesis Inhibitors; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab