title: Neurodevelopmental Outcomes in Infants with Retinopathy of Prematurity and Bevacizumab Treatment.
abstract: OBJECTIVE
  The current study aims to investigate the neurodevelopment of premature infants after intravitreal injections of bevacizumab (IVB) for the treatment of retinopathy of prematurity (ROP) up to the age of 2 years.
  
  
  METHODS
  The study design was retrospective observational case series conducted at an institutional referral center. Infants with type 1 ROP were classified into 3 groups: laser only, IVB only, and a combination of IVB and laser treatment. Main Outcome Measures were neurodevelopmental outcomes of the patients after treatment were assessed by Bayley Scales for Infant Development.
  
  
  RESULTS
  Sixty-one patients who finished the neurodevelopmental survey were included. No detrimental effects on neurodevelopment were found in IVB group compared with the patients who received laser treatment only. The patients in the IVB + laser group had a higher incidence of significant mental (p = 0.028) and psychomotor (p = 0.002) impairment at 24 months than the patients in the laser group. The odds ratio of having severe psychomotor defects in the IVB + laser group was 5.3 compared with the laser group (p = 0.041). The causal source for the differences that were detected remained unknown due to lack of randomization in the study and accompanying bias in patient selection.
  
  
  CONCLUSIONS
  Two years after laser and/or intravitreal injections of bevacizumab for infants with retinopathy of prematurity, no difference on neurodevelopment for those who received only bevacizumab versus only laser treatment were found. Those infants who required rescue therapy with laser or bevacizumab injection after initial, unsuccessful treatment showed some detrimental, neurodevelopmental effects.
authors.affiliation: Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan.|Chang Gung University, College of Medicine, Taoyuan, Taiwan.
authors.forename: Reyin
authors.initials: R
authors.lastname: Lien
authors.affiliation: Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Mu-Hsien
authors.initials: MH
authors.lastname: Yu
authors.affiliation: Laboratory for Epidemiology, Department of Health Care Management, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Kuang-Hung
authors.initials: KH
authors.lastname: Hsu
authors.affiliation: Laboratory for Epidemiology, Department of Health Care Management, Chang Gung University, Taoyuan, Taiwan.|Department of Health Care Administration, Oriental Institute of Technology, New Taipei City, Taiwan.|Department of Business Administration, National Taiwan University, Taipei, Taiwan.
authors.forename: Pei-Ju
authors.initials: PJ
authors.lastname: Liao
authors.affiliation: Chang Gung University, College of Medicine, Taoyuan, Taiwan.|Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Yen-Po
authors.initials: YP
authors.lastname: Chen
authors.affiliation: Chang Gung University, College of Medicine, Taoyuan, Taiwan.|Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Chi-Chun
authors.initials: CC
authors.lastname: Lai
authors.affiliation: Chang Gung University, College of Medicine, Taoyuan, Taiwan.|Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Wei-Chi
authors.initials: WC
authors.lastname: Wu
mesh_terms: D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000068258:Bevacizumab / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002657:Child Development / Q000187:drug effects*; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D008607:Intellectual Disability / Q000209:etiology; D058449:Intravitreal Injections; D053685:Laser Therapy / Q000009:adverse effects*; D011596:Psychomotor Disorders / Q000209:etiology; D012178:Retinopathy of Prematurity / Q000188:drug therapy / Q000628:therapy*
chemical_list: D020533:Angiogenesis Inhibitors; D000068258:Bevacizumab
references.citation: N Engl J Med. 2004 Jun 3;350(23):2335-42
references.pmid: 15175435
references.citation: Clin Pediatr (Phila). 1993 Apr;32(4):203-8
references.pmid: 7681737
references.citation: Ophthalmology. 2011 Jan;118(1):176-83
references.pmid: 20673589
references.citation: Arch Ophthalmol. 2003 Dec;121(12):1684-94
references.pmid: 14662586
references.citation: FASEB J. 2001 May;15(7):1215-7
references.pmid: 11344092
references.citation: Br J Ophthalmol. 2008 Apr;92(4):518-22
references.pmid: 18211942
references.citation: Development. 1992 Feb;114(2):521-32
references.pmid: 1592003
references.citation: Acta Ophthalmol. 2008 Aug;86(5):585-6
references.pmid: 18081904
references.citation: Ophthalmology. 2000 Feb;107(2):324-7; discussion 328
references.pmid: 10690834
references.citation: Am J Ophthalmol. 2013 Jan;155(1):150-158.e1
references.pmid: 22967867
references.citation: Am J Ophthalmol. 2006 Dec;142(6):1054-6
references.pmid: 17157590
references.citation: Invest Ophthalmol Vis Sci. 2010 Jul;51(7):3701-8
references.pmid: 20181842
references.citation: Pediatr Phys Ther. 2004 Fall;16(3):149-56
references.pmid: 17057542
references.citation: Ophthalmology. 2009 Nov;116(11):2165-9
references.pmid: 19700197
references.citation: Am J Ophthalmol. 2006 Oct;142(4):685-8
references.pmid: 17011869
references.citation: Br J Ophthalmol. 2009 Apr;93(4):452-6
references.pmid: 19074916
references.citation: Pediatrics. 2005 Aug;116(2):333-41
references.pmid: 16061586
references.citation: Acta Ophthalmol. 2008 Mar;86(2):231-2
references.pmid: 17888083
references.citation: Ophthalmology. 2009 Sep;116(9):1599-603
references.pmid: 19371954
references.citation: Am J Ophthalmol. 2009 Oct;148(4):536-543.e2
references.pmid: 19660736
references.citation: N Engl J Med. 2011 Feb 17;364(7):603-15
references.pmid: 21323540
references.citation: Retina. 2006 Mar;26(3):275-8
references.pmid: 16508426
references.citation: Am J Ophthalmol. 2012 Feb;153(2):327-333.e1
references.pmid: 21930258
references.citation: Am J Ophthalmol. 2009 Jul;148(1):59-65.e1
references.pmid: 19375689
references.citation: Nat Med. 1995 Oct;1(10):1024-8
references.pmid: 7489357
references.citation: JAMA Ophthalmol. 2015 Apr;133(4):391-7
references.pmid: 25569026
references.citation: Ophthalmology. 2007 May;114(5):855-9
references.pmid: 17467524
references.citation: Graefes Arch Clin Exp Ophthalmol. 2009 Jan;247(1):27-33
references.pmid: 18696094
references.citation: J Neurosci. 2013 Jan 9;33(2):411-23
references.pmid: 23303921
references.citation: Retina. 2006 Apr;26(4):383-90
references.pmid: 16603955
references.citation: Am J Respir Crit Care Med. 2001 Jun;163(7):1723-9
references.pmid: 11401896
references.citation: Ophthalmology. 2006 Oct;113(10):1695.e1-15
references.pmid: 17011951
references.citation: Retina. 2013 Feb;33(2):329-38
references.pmid: 23099498