The results of intravitreal bevacizumab monotherapy for treating aggressive posterior retinopathy of prematurity and Type 1 retinopathy of prematurity

Abstract

Objectives: This study evaluated the efficacy of intravitreal bevacizumab (IVB) monotherapy for aggressive posterior retinopathy of prematurity (APROP) and Type 1 retinopathy of prematurity (ROP), along with recurrence rates and treatment outcomes for recurrences. Methods: This retrospective cohort study reviewed the records of infants with ROP (Type 1 and APROP), who received IVB treatment between March 2013 and February 2018. Results: A total of 257 eyes from 130 cases (unilateral eyes in three cases) were included. Cases were followed for 121.7 ± 45.7 weeks (range: 70–260 weeks). Recurrence requiring treatment was determined in 14.8% of all eyes at a mean of 9.6 ± 2.7 weeks (range: 6–15 weeks) after initial treatment and a mean of 42.3 ± 2.2 weeks (range: 38–48 weeks) postmenstrual age. Recurrence requiring treatment was observed in 20.8% of APROP and 5.8% of Type 1 ROP eyes at a statistically significant difference (p = 0.001). Persistent avascular areas were found in 54 eyes (25.8%) at the corrected age of 1 year, and prophylactic laser treatment was applied. This was statistically significantly higher in APROP (38.6%) than in Type 1 ROP (10.5%) (p < 0.001). An unfavourable structural outcome (progression to retinal detachment) occurred in one eye (0.4%), which developed insufficient regression and progression. Conclusions: IVB monotherapy is effective for APROP and Type 1 ROP with Zone 1 and posterior Zone 2 localisation. However, because of recurrences requiring treatment and persistent peripheral avascular areas, severe, late complications must be considered, and follow-up examinations must be made. Prophylactic laser treatment for persistent avascular areas seems effective for minimising long-term complications.