Abnormal vascularization found in half of bevacizumab-treated ROP patients

This retrospective study found that bevacizumab injections did not completely restore normal peripheral retinal vascularization in half of a small group of neonates with zone I or II ROP.

The authors reviewed the medical records and fluorescein angiography (FA) images of 10 neonates (20 eyes) who received intravitreal bevacizumab injections as the only treatment for zone I and posterior zone II ROP between August 2007 and November 2012. The interval between treatment and FA ranged from 27 to 224 weeks.

All eyes showed initial resolution of posterior disease after bevacizumab injection. However, 11 of the 20 eyes had not achieved normal vascularization, using a distance of 2 disc diameters from the ora serrata to vascular termini as the upper limit of allowable avascular retina in children.

They conclude that although intravitreal bevacizumab can be very effective in causing resolution of zone I and posterior zone II ROP, avascular peripheral retinas may continue to keep infants at risk even many years after treatment. Careful examination using FA allows accurate visualization of risk factors, such as the extent of avascular retina and the presence of dye leakage.