Serious, long-term ocular effects seen after bevacizumab treatment vs laser in eyes with ROP
Treatment with bevacizumab for acute-phase retinopathy of prematurity (ROP), compared with laser, is associated with greater incidence of potentially serious and long-term ocular effects as shown by fluorescein angiography (FA), according to a study.
Abnormalities were seen at the periphery (avascular area, vessel leakage, shunts, abnormal vessel branching and tangles) or the posterior pole (hyperfluorescent lesions, absence of foveal avascular zone) in all 20 eyes treated with bevacizumab at 4 years of age.
On the other hand, these lesions were not present in most of the eyes that underwent laser treatment. Among the 19 laser-treated eyes, one had leakage, three had shunts and tangles, and another three had macular abnormalities.
In this single, randomized, controlled trial, the investigators compared structural outcome at age 4 years of eyes treated with intravitreal injection of bevacizumab with that of fellow eyes treated with conventional laser photoablation in type 1 ROP.
All inborn babies with type 1 zone 1 ROP (n=21; 42 eyes) at the Neonatal Intensive Care Unit of the Catholic University in Rome from 1 September 2009 to 31 March 2012 were enrolled. In 21 infants, one eye was randomly assigned to receive an intravitreal injection of 0.5 mg bevacizumab, while the fellow eye underwent conventional laser photoablation.
The investigators performed digital retinal imaging and FA at an average of 4 years following treatment in follow-up. Two experts examined fluorescein angiograms to document retinal and choroidal findings.