Low-Dose Bevacizumab Linked to Positive Outcomes in Retinopathy of Prematruity

ROP Exam on baby.
UNDATED PHOTO: At Bascolm Palmer Hospital, Dr. Steve Christiansen performs an ROP (Retinopathy of Prematurity) exam on a premature ICU baby 1992 in Miami, Florida. Premies are at high risk for retinal problems.It is widely believed that sight is the most complex of the five senses. It is also often thought to be our most valued, so much so that scientists are engaged in a constant endeavor to fully understand sight so that they may better fight the seemingly endless battle against blindness. (Photo by Joe McNally/Getty Images)
Presenters reviewed data from 120 infants diagnosed with type I ROP from 2 sequential dose de-escalation studies

This article is part of Ophthalmology Advisor’s Focus on Retina coverage from the 2021 meeting of the American Academy of Ophthalmology, held in New Orleans from November 12 to 15, 2021. The team at Ophthalmology Advisor will be reporting on a variety of the research presented by the retinal experts at the AAO. Check back for more from the AAO 2021 Meeting.


Researchers reported positive retinal outcomes for infants with type I retinopathy of prematurity (ROP) treated with very low-dose intravitreal bevacizumab (IVB) after 12 months, according to results presented at the Academy of Ophthalmology 2021 annual meeting, held in New Orleans from November 12-15. 

The study consisted of 120 infants diagnosed with type I ROP from 2 sequential dose de-escalation studies of IVB administered to study eyes. Fellow eyes received 1 dosage-level higher than the study eyes. After 1 month of success or failure, treatment was managed per investigator. 

By 1-year, additional ROP treatment was given to 55% study and 56% fellow eyes. Researchers reported that study eyes were retreated in the case of severe ROP (5% failures, 20% recurrence) and persistent avascular retina (29%). The team found that a lower initial dose was associated with earlier recurrence (P <.001). By 12 months, retinal and anterior segment outcomes were good. Media refraction was -0.31 D and strabismus occurred in 29% of infants. 

“Very low-dose IVB as initial treatment for type I ROP has good retinal outcomes and modest recurrence; lower doses were associated with earlier recurrence,” researchers concluded. 

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Freedman SF, Wallace DK, Kraker R, et al. Very low-dose bevacizumab for ROP: recurrences, additional treatments and 12-month outcomes. Paper presented at: American Academy of Ophthalmology 2021 Annual Meeting; November 12-15, 2021; New Orleans. Abstract PA014.