Intravitreal bevacizumab appears to be safe in treatment of retinopathy of prematurity

The use of intravitreal bevacizumab appears to be safe in preterm infants for treatment of retinopathy of prematurity, according to a long-term multicenter study.

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The 9-year study performed in Mexico, Chile and India focused on systemic and adverse events, and included 418 eyes of 262 infants. Mean weight at birth was 1,338.3 grams, ranging from 600 grams to 1,800 grams. Average age at time of birth was 30 weeks, and average age at time of treatment was 36 weeks.

Dr Maria Martinez-Castellanos, MD, from Mexico, who was instrumental in the conduct of this study, presented the study findings at the American Society of Retina Specialists meeting in Vienna, Austria. The study recorded 47 systemic potential adverse events, including three deaths not related to bevacizumab: one due to sepsis, one after brain surgery and one after blood transfusion, while 22 subjects had psychomotor development retardation, six had respiratory distress syndrome, nine had intraventricular hemorrhage, and one each had cerebellar hypoplasia and dysmorphic syndrome.

Seventy-three local adverse events were reported, including 68 eyes with subconjunctival hemorrhage, 14 eyes with persistent avascular peripheral retina, six eyes with self-limited vitreous hemorrhage, three eyes with peripheral fibrous avascular membrane, one eye with subretinal hemorrhage and one eye with rhegmatogenous retinal detachment.

Dr Martinez-Castellanos mentioned during the presentation that most of the adverse events were related to the technique of doing the injection or preexisting conditions. She went on to add that if the retina was partially detached, it tended to detach even more. As far as systemic events were concerned, the researchers could not say if they were related to bevacizumab or to the prematurity itself.

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