Safety and efficacy of preoperatively intravitreal injection of bevacizumab for stage 4 retinopathy of prematurity

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XU Yu(Department of Ophthalmology, Xinhua Hospital, Shanghai Jiaotong University, Shanghai 200092, China)
ZHU Ying(Department of Ophthalmology, Xinhua Hospital, Shanghai Jiaotong University, Shanghai 200092, China)
LI Jia-kai(Department of Ophthalmology, Xinhua Hospital, Shanghai Jiaotong University, Shanghai 200092, China)
Journal Title:
Chinese Journal of Ocular Fundus Diseases
Volume 28, Issue 01, 2012
Key Word:
Retinopathy of prematurity/drug therapy;Antibodies, monoclonal/therapeutic use;Vitrectomy

Abstract: Objective To observe the safety and efficacy of bevacizumab pretreatment in vitrectomy for vascularly active stage 4 retinopathy of prematurity (ROP).Methods A retrospective case series of 16eyes of 8 patients with vascularly active stage 4 ROP who received an intravitreal injection of bevacizumab were studied.An intravitreal injection of 0.625 mg bevacizumab was performed one week prior to planned vitrectomy.Five days after injection,the eyes were examined by indirect ophthalmoscopy and documented with fundus photography using a RetCam Ⅱ to evaluate the vascular activity.Lens-sparing vitrectomy was performed in 14 eyes,while vitrectomy combined with lensectomy was performed in 2 eyes,one week after the injection.Three months after vitrectomy,the retinal status and lens clarity were observed.Results All patients showed remarkable regression of the fibrovascular membrane with clinically absent vascular component 5 days after the injection. No adverse events occurred. Three months after vitrectomy,anatomical attachment was achieved in 15 eyes (93.75 % ),1 eye (6.25 % ) had partial attachment.The lens remained clear in all the eyes. Conclusion Intravitreal bevacizumab administrated prior to vitrectomy reduced neovascularization safely and effectively for stage 4 ROP.

  • [1]Polly AQ, Antonia C Jr. Current understanding and management of retinopathy of prematurity. Curr Opin Ophthalmol,2007,18:228-234.
  • [2]Sonmez K,Drenser KA,Capone A Jr,et al.Vitreous levels of stromal cell-drived factor 1 and vascular endothelial growth factor in patients with retinopathy of prematurity.Ophthalmolgy,2008,115:1065-1070.
  • [3]Chong LP,Machemer R,de Juan E Jr.Vitrectomy for advanced stages of retinopathy of prematurity.Am J Ophthalmol,1986,102:710-716.
  • [4]Lakhanpal RR,Fortun JA,Chan-Kai B,et al.Lensectomy and vitrectomy with and without intravitreal triamcinolone acetonide for vascularly active stage 5 retinal detachments in retinopathy of prematurity.Retina,2006,26:736-740.
  • [5]Hartnett ME. Features associated with surgical outcome in patients with stage 4 and 5 retinopathy of prematurity.Retina,2003,23:322-329.
  • [6]Spaide RF,Laud K,Fine HF,et al.Intravitreal bevacizumab treatment of choroidal neovascularization secondary to agerelated macular degeneration.Retina,2006,26:383-390.
  • [7]Andreoli CM, Miller JW. Anti-vascular endothelial growth factor therapy for ocular neovascular disease. Curr Opin Ophthalmol,2007,18:502-508.
  • [8]The International Committee for the Classification of the Late Stages of Retinopathy of Prematurity. An international classification of retinopathy of prematurity Ⅱ:the classification of retinal detachment.Arch Ophthalmol,1987,105:906-912.
  • [9]Yu YS,Kim SJ,Kim SY,et al. Lens-sparing vitrectomy for stage 4 and stage 5 retinopathy of prematurity. Kor J Ophthalmol,2006,20:113-117.
  • [10]Capone A Jr,Trese MT. Lens sparing vitreous surgery for tractional stage 4a retinopathy of prematurity.Ophthalmology,2001,108:2068-2070.
  • [11]Prenner JL,Capone A Jr,Trese MT.Visual outcomes after lens sparing vitrectomy for stage 4a retinopathy of prematurity.Ophthalmology,2004,111:2271-2273.
  • [12]Lakhanpal RR,Sun RL,Albini TA,et al.Anatomic success rate after 3-port lens sparing vitrectomy in stage 4a or 4b retinopathy of prematurity. Ophthalmology,2005,112:1569-1573.
  • [13]Recchia FM,Capone A Jr. Contemporary understanding and management of retinopathy of prematurity.Retina,2004,24:283-292.
  • [14]Hubbard GB 3rd, Cherwich DH, Burian G. Lens-sparing vitrectomy for stage 4 retinopathy of prematurity.Ophthalmology,2004,111:2274-2277.
  • [15]Lynch SS,Cheng CM. Bevacizumab for neovascular ocular diseases.Ann Pharmacother,2007,41:614-625.
  • [16]Kusaka S,Shima C,Wada K,et al. Efficacy of intravitreal injection of bevacizumab for severe retinopathy of prematurity:a pilot study.Br J Ophthalmol,2008,92:1450-1455.
  • [17]Nazari H,Modarres M,Parvaresh MM,et al. Intravitreal bevacizumab in combination with laser therapy for the treatment of severe retinopathy of prematurity associated with vitreous or retinal hemorrhage.Graefes Arch Clin Exp Ophthalmol,2010,248:1713-1718.
  • [18]Kim MJ,Kim S,Yu YS. The risk for retinal detachment associated with hemorrhages pre-and postlaser treatment in retinopathy of prematurity.Retina,2008,28:1451-1457.
  • [19]Maguir AM,Trese MT. Lens-sparing vitreoretinal surgery in infants.Arch Ophthalmol,1992,110:284-286.
  • [20]Ferrara N,Davis-Smyth T.The biology of vascular endothelial growth factor.Endocrine Rev,1997,18:4-25.
  • [21]Ishida S,Usui T,Yamashiro K,et al. VEGF 164-mediated inflammation is required for pathological,but not physiological,ischemia-induced retinal neovascularization.J Exp Med,2003,198:483-489.
  • [22]Kong L,Mintz-Hittner HA,Penland RL,et al. Intravitreal bevacizumab as anti-vascular endothelial growth factor therapy for retinopathy of prematurity: a morphologic study. Arch Ophthalmol,2008,126:1161-1163.
  • [23]Mintz-Hittner HA,Kennedy KA,Chuang AZ,et al.Efficacy of intravitreal bevacizumab for stage 3+ retinopathy of prematurity.N EnglJ Med,2011,364:603-615.
  • [24]Chung EJ,Kim JH,Ahn HS,et al. Combination of laser photocoagulation and intravitreal bevacizumab for aggressive zone Ⅰ retinopathy of prematurity. Graefe's Arch Clin Exp Ophthalmol,2007,245:1727-1730.
  • [25]Shah PK, Narendran V, Tawansy KA, et al. Intravitreal bevacizumab for post laser anterior segment ischemia in aggressive posterior retinopathy of prematurity. India J Ophthalmol,2008,92:1450-1455.
  • [26]Kychenthal A, Dorta P. Vitrectomy after intravitreal bevacizumab for retinal detachment in retinopathy of prematurity.Retina,2010,30(Suppl):32-36.
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