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      Growth and neurodevelopmental status in patients with retinopathy of prematurity treated with intravitreal bevacizumab: a case–control study

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          Abstract

          Background

          The current study aimed to evaluate growth and neurodevelopmental status in patients with retinopathy of prematurity (ROP) treated with intravitreal bevacizumab (IVB).

          Methods

          This historical cohort study was conducted on neonates with ROP who were treated with IVB and age and birth weight-matched controls who did not need IVB. Apgar score less than five, history of blood transfusion and history of infectious diseases were among exclusion criteria. Indirect ophthalmoscopic examinations were performed till complete retinal vascularization. Growth and neurodevelopmental status were evaluated by Age and Stages Questionnaire (ASQ) at the ages of 6, 12, and 18 months. Developmental milestones were assessed in five areas (gross motor, fine motor, personal-social status, problem-solving, and relationship) and overall issues.

          Results

          A total of 34 cases and 36 controls were included in the present study. Birth weight and corrected gestational age were not statistically different between the groups. In a follow-up period of 18 months, bevacizumab was effective as a primary treatment in the treatment of severe cases of ROP. There was no significant difference between the two groups regarding the five areas and overall issues in follow-up intervals (P > 0.05).

          Conclusions

          The obtained results did not show any growth and neurodevelopmental differences between treatment-naïve infants and those receiving IVB for the treatment of ROP.

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          Most cited references23

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          The International Classification of Retinopathy of Prematurity revisited.

          (2005)
          The International Classification of Retinopathy of Prematurity (ICROP) was published in 2 parts, the first in 1984 and later expanded in 1987. It was a consensus statement of an international group of retinopathy of prematurity experts. The original classification has facilitated the development of large multicenter clinical treatment trials and furthered our understanding of this potentially blinding disorder. With improved imaging techniques in the nursery, we are able to offer a more quantitative approach to some of the characteristics described in the ICROP. An international group of pediatric ophthalmologists and retinal specialists has developed a consensus document that revises some aspects of ICROP. Few modifications were felt to be needed. The aspects that differ from the original classification include introduction of (1) the concept of a more virulent form of retinopathy observed in the tiniest babies (aggressive, posterior ROP), (2) a description of an intermediate level of plus disease (pre-plus) between normal posterior pole vessels and frank plus disease, and (3) a practical clinical tool for estimating the extent of zone I.
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            Efficacy of intravitreal bevacizumab for stage 3+ retinopathy of prematurity.

            Helen Mintz-Hittner, Kathleen A. Kennedy, Alice Chuang (2011)
            Retinopathy of prematurity is a leading cause of childhood blindness worldwide. Peripheral retinal ablation with conventional (confluent) laser therapy is destructive, causes complications, and does not prevent all vision loss, especially in cases of retinopathy of prematurity affecting zone I of the eye. Case series in which patients were treated with vascular endothelial growth factor inhibitors suggest that these agents may be useful in treating retinopathy of prematurity. We conducted a prospective, controlled, randomized, stratified, multicenter trial to assess intravitreal bevacizumab monotherapy for zone I or zone II posterior stage 3+ (i.e., stage 3 with plus disease) retinopathy of prematurity. Infants were randomly assigned to receive intravitreal bevacizumab (0.625 mg in 0.025 ml of solution) or conventional laser therapy, bilaterally. The primary ocular outcome was recurrence of retinopathy of prematurity in one or both eyes requiring retreatment before 54 weeks' postmenstrual age. We enrolled 150 infants (total sample of 300 eyes); 143 infants survived to 54 weeks' postmenstrual age, and the 7 infants who died were not included in the primary-outcome analyses. Retinopathy of prematurity recurred in 4 infants in the bevacizumab group (6 of 140 eyes [4%]) and 19 infants in the laser-therapy group (32 of 146 eyes [22%], P=0.002). A significant treatment effect was found for zone I retinopathy of prematurity (P=0.003) but not for zone II disease (P=0.27). Intravitreal bevacizumab monotherapy, as compared with conventional laser therapy, in infants with stage 3+ retinopathy of prematurity showed a significant benefit for zone I but not zone II disease. Development of peripheral retinal vessels continued after treatment with intravitreal bevacizumab, but conventional laser therapy led to permanent destruction of the peripheral retina. This trial was too small to assess safety. (Funded by Research to Prevent Blindness and others; ClinicalTrials.gov number, NCT00622726.).
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              Neurodevelopmental Outcomes Following Bevacizumab Injections for Retinopathy of Prematurity.

              Julie Morin, Thuy Mai Luu, Rosanne Superstein … (2016)
              Bevacizumab intravitreal injection, a vascular endothelial growth factor inhibitor, is used to treat retinopathy of prematurity (ROP). However, concerns have been raised regarding its systemic absorption and effect on developing tissues including brain. This study compared neurodevelopment at 18 months' corrected age in preterm infants of <29 weeks' gestation treated with bevacizumab versus laser ablation.
              Article 0 comments Cited 86 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Nasser Shoeibi:
                ORCID: http://orcid.org/0000-0003-3544-0105
                shoeibin@mums.ac.ir
                Journal
                Journal ID (nlm-ta): Int J Retina Vitreous
                Journal ID (iso-abbrev): Int J Retina Vitreous
                Title: International Journal of Retina and Vitreous
                Publisher: BioMed Central (London )
                ISSN (Electronic): 2056-9920
                Publication date (Electronic): 16 November 2021
                Publication date PMC-release: 16 November 2021
                Publication date Collection: 2021
                Volume: 7
                Electronic Location Identifier: 68
                Affiliations
                [1 ]GRID grid.411583.a, ISNI 0000 0001 2198 6209, Eye Research Center, , Mashhad University of Medical Sciences, ; Qarani Blvd, 9195965919 Mashhad, Iran
                [2 ]GRID grid.411583.a, ISNI 0000 0001 2198 6209, Neonatal Research Center, , Mashhad University of Medical Sciences, ; Mashhad, Iran
                [3 ]GRID grid.411583.a, ISNI 0000 0001 2198 6209, Clinical Research Development Unit, , Mashhad University of Medical Sciences, ; Mashhad, Iran
                Author information
                http://orcid.org/0000-0003-3544-0105
                Article
                Publisher ID: 340
                DOI: 10.1186/s40942-021-00340-6
                PMC ID: 8594208
                PubMed ID: 33397439
                SO-VID: ddda314e-c911-4004-89ee-76dc7643d608
                Copyright © © The Author(s) 2021
                License:

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                Date received : 10 September 2021
                Date accepted : 18 October 2021
                Funding
                Funded by: Vice-Chancellor of Research of Mashhad University of Medical Sciences
                Award ID: 930125
                Award Recipient :
                Categories
                Subject: Original Article
                Custom metadata
                issue-copyright-statement © The Author(s) 2021

                Keywords: retinopathy of prematurity,growth,neurodevelopmental status,bevacizumab,retina
                Data availability:
                Keywords: retinopathy of prematurity, growth, neurodevelopmental status, bevacizumab, retina

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