Comparison of Ocular and Developmental Outcomes in Laser-and Bevacizumab-treated Infants with Retinopathy of Prematurity

Abstract

Purpose: To compare vision and developmental outcomes in infants who were treated with intravitreal bevacizumab injection (IVB) versus laser for retinopathy of prematurity (ROP). Methods: Forty-two infants were enrolled in this study and treated with either IVB at 0.625 mg per eye, per dose (22 patients, 43 eyes), or laser (20 patients, 37 eyes) for type I ROP. Systemic complications were compared between these two groups. Structural examinations and cycloplegic refractions were performed at age 1 year. Body weight gains were collected from birth to 36 weeks of postnatal age. Neurodevelopmental assessment was done at 1 year chronological age. Results: At 1 year of age, four eyes (10.8%) in the laser-treated group and none (0.0%) in the IVB-treated group had unfavorable structural outcome; ten (30%) eyes in the IVB-treated group and 17 (53%) eyes in the laser-treated group were myopic, p =0.03; the mean spherical equivalent was -0.03 diopter (D) in the IVB-treated group and -2.94 D in the laser-treated group, p=0.02. The mean visual acuity in LogMar was 0.54 (SD, 0.34) and 0.58 (SD, 0.52) in the IVB- and laser-treated groups, respectively (p=0.31). The average weekly weight gain continued at normal rates in both groups after treatment. Seven of ten patients (70%) in the IVB-treated group and six of nine patients (67%) in the laser-treated group were categorized as severely developmentally delayed.  Conclusions: Bevacizumab intravitreal injection had similar short-term efficacy compared to laser treatment with regard to treatment of type I ROP but was associated with a lower prevalence of high myopia.