Refractive and Biometric Outcomes Following Bevacizumab Versus Laser for Retinopathy of Prematurity
Claire Hartnett, MD; Michael O’Keeffe, MD
Temple Street Children’s University Hospital
Introduction: In 2010 and 2011, we conducted a prospective randomised study to compare the treatment of intravitreal Bevacizumab in one eye versus diode laser in the fellow eye of 15 premature infants with symmetrical zone 1 or posterior zone 2 ROP.
Methods: All 15 children were reviewed in 2017 with visual acuity, cycloplegic refraction and biometry recordings made of each eye that was treated.
Results: The laser treated eyes had a mean spherical equivalent of -3.06 Dioptres. The bevacizumab treated eyes had a mean spherical equivalent of -0.8 Dioptres. This was statistically significant. The laser-treated eyes had reduced mean anterior chamber depths (2.71mm) compared with the Bevacizumab treated fellow eyes (3.13mm) and this was statistically significant. The mean axial length of the lasered eyes was longer (21.21mm) compared to the mean axial length of the Bevacizumab treated eyes at 20.84mm.
Discussion: These results highlight the higher myopic results with narrow anterior chambers, steeper corneas and longer axial lengths in laser treated eyes compared to their fellow eyes which were treated with Bevacizumab.
Conclusion: These findings can be attributed to the adverse laser effects on anterior segment development in the premature infant eye. These findings will be of use to clinicians who use both treatments in premature infants and highlight benefits of Bevacizumab versus Laser.
References: Hwang CK et al. Outcomes after Intravitreal Bevacizumab versus laser photocoagulation for retinopathy of prematurity: a 5-year retrospective analysis. Ophthalmology 2015;122:1008-1015.
Darlow BA, Ells AL, Gilbert CE, et al. Are we there yet? Bevacizumab therapy for retinopathy of prematurity. Arch Dis Child Fetal Neonatal Ed 2013;98:F170-174.
Issac M, Mireskandari K, Tehrani N. Treatment of type 1 retinopathy of prematurity with bevacizumab versus laser. JAAPOS 2015;19:140-144