Bevacizumab tested in treatment of severe ROP

May 8, 2007

In a small case series, all eyes in infants treated with bevacizumab (Avastin, Genentech) for retinopathy of prematurity (ROP) showed a decrease in fluorescein leakage from neovascularization after the injection. Although this series involved only five eyes in three patients with short-term follow-up, the results suggest that bevacizumab could be an alternative for treatment of severe ROP that is refractive to conventional laser treatment, said Shunji Kusaka, MD, Department of Ophthalmology, Osaka University Medical School, Suita, Japan.

In a small case series, all eyes in infants treated with bevacizumab (Avastin, Genentech) forretinopathy of prematurity (ROP) showed a decrease in fluorescein leakage from neovascularizationafter the injection. Although this series involved only five eyes in three patients with short-termfollow-up, the results suggest that bevacizumab could be an alternative for treatment of severe ROPthat is refractive to conventional laser treatment, said Shunji Kusaka, MD, Department ofOphthalmology, Osaka University Medical School, Suita, Japan.

The patients had zone 1 ROP, had developed partial retinal detachments, and were consideredunresponsive to treatment. Gestational age ranged from 24 to 26 weeks and birth weight from 700 to962 g. Under general anesthesia, the patients were given intravitreal injections of 0.5 to 0.75 mg ofbevacizumab. The drug was administered following vitrectomy in two patients and was the soletreatment in three patients.

"In each eye, fluorescein angiography showed that vascular activity was reduced and the retina wassuccessfully re-attached," Dr. Kusaka said. However, one eye progressed from Stage 3 to Stage 4ROP.

Dr. Kusaka said that he would like to test this therapy in patients with earlier stages of ROP.However, one of the safety concerns that must be addressed in future studies is the drug's effect onphysiological vessel growth, In addition, functional tests should be performed; none were conductedin this series.