Low-dose bevacizumab effective for treating retinopathy of prematurity
Low-dose bevacizumab yields excellent retinal structural outcomes in the treatment of retinopathy of prematurity (ROP), although a number of infants may still require additional treatment, as shown in a study.
A total of 61 premature infants with type 1 ROP received bevacizumab intravitreal injections at de-escalating doses of 0.25, 0.125, 0.063 or 0.031 mg in the study eye. If needed, fellow eyes received treatment at one-dose level higher: 0.625, 0.25, 0.125 or 0.063 mg, respectively. Additional treatment was or was not given after 4 weeks.
The main outcomes investigated were early and late ROP recurrences, additional treatments, and structural outcomes after 6 months.
Additional treatment was administered to 25 of 61 study eyes (41 percent) due to early treatment failure (within 4 weeks; n=3), late recurrence of ROP (after 4 weeks; n=11) or persistent avascular retina (n=11).
Specifically, retreatment for early failure or late recurrence occurred in two of 11 eyes (18 percent) given 0.25 mg, four of 16 eyes (25 percent) given 0.125 mg, eight of 24 eyes (33 percent) given 0.063 mg and none of 10 eyes (0 percent) given 0.031 mg.
By 6 months corrected age, 56 infants had ROP regression with normal posterior poles, one developed a stage 5 retinal detachment, and four had died of pre-existing medical conditions.
Further investigations are being conducted to test lower doses of bevacizumab, which may lead to enhanced normal retinal vascularization while posing lower systemic risk, researchers said.