title: CONCURRENT SCLERAL BUCKLE AND INTRAVITREAL BEVACIZUMAB FOR ADVANCED RETINOPATHY OF PREMATURITY-RELATED RETINAL DETACHMENT.
abstract: BACKGROUND
  The preoperative use of intravitreal bevacizumab in Stage 4 or 5 retinopathy of prematurity (ROP) can reduce vascular endothelial growth factor load and bleeding risk; however, it can induce traction and exacerbate a tractional retinal detachment. Concurrent placement of a scleral buckle may reduce these risks and obviate future vitrectomy.
  
  
  METHODS
  A retrospective analysis of eyes treated for Stage 4 and 5 ROP with concurrent intravitreal bevacizumab and scleral buckle was performed. Retinal reattachment and need for vitrectomy were studied.
  
  
  RESULTS
  Thirteen eyes from 10 infants were treated with concurrent intravitreal bevacizumab and scleral buckle. Nine eyes were Stage 4a, 2 were Stage 4b, and 2 were Stage 5. All eyes with Stage 4 ROP achieved macular attachment at last follow-up. All the eyes with 4a ROP achieved retinal reattachment: 4 (44.4%) with buckle alone and 5 (55.6%) with subsequent vitrectomy. All 4 eyes with Stage 4b or 5 ROP required vitrectomy.
  
  
  CONCLUSIONS
  Concurrent intravitreal bevacizumab and scleral buckle may serve as a bridge to vitrectomy and, in some instances, may obviate the need for subsequent intervention.
authors.affiliation: *Department of Ophthalmology and Visual Sciences, Vanderbilt University School of Medicine, Vanderbilt Eye Institute, Nashville, Tennessee; †University of Illinois at Chicago, Eye and Ear Infirmary, Chicago, Illinois; and ‡Retina Consultants, Ltd., Des Plaines, Illinois.
authors.forename: Rohan J
authors.initials: RJ
authors.lastname: Shah
authors.forename: Jose M
authors.initials: JM
authors.lastname: Garcia-Gonzalez
authors.forename: Michael P
authors.initials: MP
authors.lastname: Blair
authors.forename: John
authors.initials: J
authors.lastname: Galasso
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Shapiro
mesh_terms: D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D000068258:Bevacizumab / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D058449:Intravitreal Injections; D008297:Male; D012163:Retinal Detachment / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D012178:Retinopathy of Prematurity / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D012189:Retrospective Studies; D012591:Scleral Buckling / Q000379:methods*; D016896:Treatment Outcome; D014792:Visual Acuity
chemical_list: D020533:Angiogenesis Inhibitors; D000068258:Bevacizumab