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Research Letters | June 2012

Significant Treatment Failure With Intravitreous Bevacizumab for Retinopathy of Prematurity

Ravi D. Patel, MD; Michael P. Blair, MD; Michael J. Shapiro, MD; Steven J. Lichtenstein, MD

Arch Ophthalmol. 2012;130(6):801-802. doi:10.1001/archophthalmol.2011.1802.

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The mainstay of treatment for retinopathy of prematurity (ROP) with risk of retinal detachment has been ablation of peripheral avascular retina through cryotherapy or laser.¹^- 2 Because ablative treatments are destructive and treatment often requires intubation and anesthesia in neonates with comorbid conditions, there has been interest in alternative treatments. Intravitreous bevacizumab injection is an emerging treatment that can be performed with minimal sedation. The BEAT-ROP study³ demonstrated a significant benefit of bevacizumab over laser in reducing treatment-requiring recurrence by 54 weeks. Given that recurrence in eyes treated with bevacizumab occurred later, at a mean (SD) of 16.0 (4.6) weeks after treatment, than in eyes treated with laser, at a mean (SD) of 6.2 (5.7) weeks after treatment, the time course of recurrence and progression of ROP is likely altered. Thus, late recurrences may not have been detected by the study.⁴ Herein, we report a case of significant treatment failure after bevacizumab monotherapy.

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Figure 1. Photographs of the right (A) and left (B) eyes demonstrating fibrovascular tissue and retinal detachment in the retrolental location.

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Figure 2. Ultrasonographic images (12 MHz) demonstrating tight funnel-shaped retinal detachment in the right (A) and left (B) eyes.

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Patel RD, Blair MP, Shapiro MJ, Lichtenstein SJ. Significant Treatment Failure With Intravitreous Bevacizumab for Retinopathy of Prematurity. Arch Ophthalmol. 2012;130(6):801-802. doi:10.1001/archophthalmol.2011.1802.

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