Single low-dose bevacizumab injection promising for treating type 1 ROP
VANCOUVER, British Columbia — A single low-dose injection of bevacizumab as primary intervention yielded a “good success rate” in treating type 1 retinopathy of prematurity, according to a study presented here.
However, “a second bevacizumab injection has not been successful in our experience,” Terry S. Kang, MD, told colleagues at the American Association for Pediatric Ophthalmology and Strabismus meeting.
Terry S. Kang
The retrospective analysis conducted at Texas Children’s Hospital, Houston, included 49 eyes that underwent injection with 0.25 mg Avastin (bevacizumab, Genentech) 2.5 mm inferior to the inferior limbus.
Patients were followed up until discharged, either with apparent full retinal vascularization or demonstrated regression without areas that were concerning for future reactivation.
Forty-three eyes (87.8%) had no recurrence requiring re-treatment after one injection. Four eyes (8.2%) required subsequent retinal laser; of these, three had undergone a second injection with bevacizumab. Two eyes (4.1%) required subsequent pars plana vitrectomy; of these, one had undergone a second injection with bevacizumab.
“The kids who ended up failing primary low-dose bevacizumab injection with just one treatment tended to be sicker children. They tended to have lower birth weights, lower gestational age and tended to have more comorbidities, causing them to have significantly worse clinical course,” Kang said.
Average age at first bevacizumab injection was postmenstrual age 35.2 weeks; average time to failure was 6.8 weeks after injection.
“The purpose of us presenting this was to show that, even with a lower dose of 0.25 mg of bevacizumab, we had good results as far as 88% success with a single injection and a low rate of unfavorable structural outcomes — 4% of eyes ultimately requiring surgery,” Kang said.
Systemic side effects remain a concern with bevacizumab injection, Kang said, and further studies are needed to establish the lowest effective dose that will treat ROP and minimize side effects. – by Patricia Nale, ELS
Reference : Kang TS. Treatment of type 1 retinopathy of prematurity with 0.25 mg intravitreal bevacizumab. Paper 12 presented at: American Association for Pediatric Ophthalmology and Strabismus 42nd annual meeting; April 6-10, 2016; Vancouver, British Columbia.
Disclosure: Kang reports no relevant financial disclosures.