First Author: K.Al Husseiny EGYPT
Co Author(s): A. Awadein M. El Agha M. Al Sada
Purpose:
To determine the effect of adding intravitreal bevacizumab to conventional laser photocoagulation in stage 3 retinopathy of prematurity (ROP).
Setting:
: Kasr Al Aini Pediatric Hospital (Abo Alrish).
Methods:
A prospective, controlled, interventional fellow eye study in patients with bilateral stage 3 ROP necessitating bilateral laser photocagulation of non-perfused retina. Patients received diode laser photocoagulation in one eye group (A) (LP group), and the same treatment in the fellow eye with the addition of an intravitreal injection of bevacizumab at the end of the procedure group (B) (LP/IVB group). The primary outcome measures were the resolution of neovascularization and occurrence of retinal detachment, and secondary outcome measures were speed of resolution of plus disease, and the intensity of the cicatricial response.
Results:
Fifteen patients met the criteria. Seven patients had zone I disease, and 8 patients had posterior zone II disease. All eyes (100%) in the LP/IVB group had complete resolution of neovascularization without the occurrence of retinal detachment. Out of the 15 eyes in the LP group, 12 eyes (80%) had complete resolution of neovascularization, while 3 eyes (20%) had persistent neovascularization, which was successfully treated with intravitreal bevacizumab and supplemental laser photocoagulation. In the latter 3 eyes, there was an exaggerated cicatricial response compared to the fellow eye. None of the eyes in the LP group developed retinal detachment. The time from primary intervention to resolution of plus disease ranged from 2-5 days in the (A) LP/IVB group, and 7-10 days in the (B) LP group.
Conclusions:
The addition of intravitreal bevacizumab (IVB) to conventional laser photocoagulation in stage 3 ROP (zones I and II) resulted in faster resolution of plus disease, more complete resolution of neovascularization, and less need for secondary intervention, without exaggeration of the cicatricial response. When IVB was added to supplemental laser treatment, the cicatricial response was more intense than cases where IVB was added to the primary laser treatment, but without the occurrence of retinal detachment. Thus IVB may be useful as an adjunct to primary laser treatment. The late addition of IVB to supplemental laser treatment requires further study.
Financial Disclosure:
None
