Advertisement

Japanese Journal of Ophthalmology

, Volume 58, Issue 3, pp 237–243 | Cite as

Intravitreal injection of bevacizumab for retinopathy of prematurity

  • Kazuki KuniyoshiEmail author
  • Koji Sugioka
  • Hiroyuki Sakuramoto
  • Shunji Kusaka
  • Norihisa Wada
  • Yoshikazu Shimomura
Clinical Investigation

Abstract

Purpose

To evaluate the outcomes of intravitreal injection of bevacizumab (IVB) for retinopathy of prematurity (ROP).

Methods

IVB was selected to be the first treatment for type 1 ROP in 8 eyes (4 patients). Bevacizumab (0.25 mg/eye) was injected into the vitreous cavity under either general anesthesia or sedation. Fundus photography and fluorescein angiography were performed before the IVB. One infant was observed to the age of 1 year 6 months, the second to 1 year 9 months, the third to 1 year 10 months, and the fourth to 2 years 0 month.

Results

Before the IVB, 6 eyes (3 patients) had ROP in zone II and 2 eyes (one patient) had ROP in zone I. The 3 infants with ROP in zone II weighed 652, 476, and 579 g with gestational ages of 24, 27, and 24 weeks at birth, respectively. The infant with ROP in zone I weighed 972 g with a gestational age of 26 weeks at birth. IVB was performed at postmenstrual ages of 33–37 weeks. The IVB was effective in all eyes with ROP in zone II and additional treatment was not required, whereas vitreous hemorrhage and cataract were found at 19 weeks and 5 months after the initial IVB in the two eyes with ROP in zone I. These two eyes required additional IVB, laser photocoagulation, and surgery.

Conclusions

Our findings suggest that eyes with type 1 ROP in zone II can be treated with IVB. Further studies are needed with a larger number of eyes.

Keywords

Retinopathy of prematurity Zone I ROP Bevacizumab Vascular endothelial growth factor Anti-VEGF therapy 

Notes

Acknowledgments

The authors thank Daishi Tsujioka, MD, Masuo Sakamoto, MD, Tsuyoshi Minami, MD and Takuya Numata, MD in the Department of Ophthalmology, Kinki University Faculty of Medicine, and Shunsuke Minakata, MD and Akane Izu, MD in the Department of Pediatrics, Kinki University Faculty of Medicine, for their continuous clinical assistance and suggestive advice on this study.

This research was supported by research grants to S.K. Y.S. and K.K. from Japan Society for the Promotion of Science, Japan, and to Y.S. and K.K. from Ministry of Health, Labour and Welfare, Japan.

Conflicts of interest

K. Kuniyoshi, None; K. Sugioka, None; H. Sakuramoto, None; S. Kusaka, None; N. Wada, None; Y. Shimomura, None.

References

  1. 1.
    Nagata M, Kobayashi Y, Fukuda H, Suekane K. Photocoagulation for the treatment of the retinopathy of prematurity. Rinsho Ganka (Jpn). 1968;22:419–26.Google Scholar
  2. 2.
    Cryotherapy for Retinopathy of Prematurity Cooperative Group. Multicenter trial of cryotherapy for retinopathy of prematurity. Preliminary results. Arch Ophthalmol. 1988;106:471–9.CrossRefGoogle Scholar
  3. 3.
    Early Treatment for Retinopathy of Prematurity Cooperative Group. Revised indications for the treatment of retinopathy of prematurity. Arch Ophthalmol. 2003;121:1684–96.PubMedCrossRefGoogle Scholar
  4. 4.
    Young TL, Anthony DC, Pierce E, Foley E, Smith LEH. Histopathology and vascular endothelial growth factor in untreated and diode laser-treated retinopathy of prematurity. J AAPOS. 1997;1:105–10.PubMedCrossRefGoogle Scholar
  5. 5.
    Stewart MW. The expanding role of vascular endothelial growth factor inhibitors in ophthalmology. Mayo Clin Proc. 2012;87:77–88.PubMedCentralPubMedCrossRefGoogle Scholar
  6. 6.
    Chung EJ, Kim JH, Ahn HS, Koh HJ. Combination of laser photocoagulation and intravitreal bevacizumab (Avastin®) for aggressive zone I retinopathy of prematurity. Graefes Arch Clin Exp Ophthalmol. 2007;245:1727–30.PubMedCrossRefGoogle Scholar
  7. 7.
    Quiroz-Mercado H, Martinez-Castellanos MA, Hernandez-Rojas ML, Salazar-Teran N, Chan RVP. Antiangiogenic therapy with intravitreal bevacizumab for retinopathy of prematurity. Retina. 2008;28(suppl):S19–25.PubMedCrossRefGoogle Scholar
  8. 8.
    Lalwani GA, Berrocal AM, Murray TG, Buch M, Cardone S, Hess D, et al. Off-label use of intravitreal bevacizumab (Avastin) for salvage treatment in progressive threshold retinopathy of prematurity. Retina. 2008;28(suppl):S13–8.PubMedCrossRefGoogle Scholar
  9. 9.
    Lee JY, Chae JB, Yang SJ, Yoon YH, Kim JG. Effects of intravitreal bevacizumab and laser in retinopathy of prematurity therapy on the development of peripheral retinal vessels. Grasefes Arch Clin Exp Ophthalmol. 2010;248:1257–62.CrossRefGoogle Scholar
  10. 10.
    Axer-Siegel R, Snir M, Ron Y, Friling R, Sirota L, Weinberger D. Intravitreal bevacizumab as supplemental treatment or monotherapy for severe retinopathy of prematurity. Retina. 2011;31:1239–47.PubMedCrossRefGoogle Scholar
  11. 11.
    Dani C, Frosini S, Fortunato P, Bertini G, Pratesi S, Pollazzi L, et al. Intravitreal bevacizumab for retinopathy of prematurity as first line or rescue therapy with focal laser treatment. A case series. J Matern Fetal Neonatal Med. 2012;25:2194–7.PubMedCrossRefGoogle Scholar
  12. 12.
    Sun HJ, Choi KS, Lee SJ. Adjunctive effect of intravitreal bevacizumab prior to lens-sparing vitrectomy in aggressive posterior retinopathy of prematurity: a case report. Jpn J Ophthalmol. 2012;56:476–80.PubMedCrossRefGoogle Scholar
  13. 13.
    Martínez-Castellanos MA, Schwartz S, Hernández-Rojas ML, Kon-Jara VA, Gracía-Aguirre G, Guerrero-Naranjo JL, et al. Long-term effect of antiangiogenic therapy for retinopathy of prematurity up to 5 years of follow-up. Retina. 2013;33:329–38.PubMedCrossRefGoogle Scholar
  14. 14.
    Kusaka S, Shima C, Wada K, Arahori H, Shimojyo H, Sato T, et al. Efficacy of intravitreal injection of bevacizumab for severe retinopathy of prematurity: a pilot study. Br J Ophthalmol. 2008;92:1450–5.PubMedCrossRefGoogle Scholar
  15. 15.
    Nonobe NI, Kachi S, Kondo M, Takai Y, Takemoto K, Nakayama A, et al. Concentration of vascular endothelial growth factor in aqueous humor of eyes with advanced retinopathy of prematurity before and after intravitreal injection of bevacizumab. Retina. 2009;29:579–85.PubMedCrossRefGoogle Scholar
  16. 16.
    Mintz-Hittner HA, Kennedy KA, Chuang AZ, BEAT-ROP Cooperative Group. Efficacy of intravitreal bevacizumab for stage 3+ retinopathy of prematurity. N Engl J Med. 2011;364:603–15.PubMedCentralPubMedCrossRefGoogle Scholar
  17. 17.
    Mintz-Hittner HA, Kuffel RR Jr. Intravitreal injection of bevacizumab (Avastin) for treatment of stage 3 retinopathy of prematurity in zone I or posterior zone II. Retina. 2008;28:831–8.PubMedCrossRefGoogle Scholar
  18. 18.
    Wu WC, Yeh PT, Chen SN, Yang CM, Lai CC, Kuo HK. Effects and complications of bevacizumab use in patients with retinopathy of prematurity: a multicenter study in Taiwan. Ophthalmology. 2011;118:176–83.PubMedCrossRefGoogle Scholar
  19. 19.
    Mintz-Hittner HA. Intravitreal pegaptanib as adjunctive treatment for stage 3+ ROP shown to be effective in a prospective, randomized, controlled multicenter clinical trial. Eur J Ophthalmol. 2012;22:685–6.PubMedGoogle Scholar
  20. 20.
    Wu WC, Kuo HK, Yeh PT, Yang CM, Lai CC, Chen SN. An updated study of the use of bevacizumab in the treatment of patients with prethreshold retinopathy of prematurity in Taiwan. Am J Ophthalmol. 2013;155:150–8.PubMedCrossRefGoogle Scholar
  21. 21.
    Jang SY, Choi KS, Lee SJ. Delayed-onset retinal detachment after an intravitreal injection of ranibizumab for zone 1 plus retinopathy of prematurity. J AAPOS. 2010;14:457–9.PubMedCrossRefGoogle Scholar
  22. 22.
    Lee BJ, Kim JH, Yu YS. Delayed onset atypical vitreoretinal traction band formation after an intravitreal injection of bevacizumab in stage 3 retinopathy of prematurity. Eye. 2012;26:903–10.PubMedCentralPubMedCrossRefGoogle Scholar
  23. 23.
    Patel RD, Blair MP, Shapiro MJ, Lichtenstein SJ. Significant treatment failure with intravitreous bevacizumab for retinopathy of prematurity. Arch Ophthalmol. 2012;130:801–2.PubMedGoogle Scholar
  24. 24.
    Hu J, Blair MP, Shapiro MJ, Lichtenstein SJ, Galasso JM, Kapur R. Reactivation of retinopathy of prematurity after bevacizumab injection. Arch Ophthalmol. 2012;130:1000–6.PubMedCrossRefGoogle Scholar
  25. 25.
    Ittiara S, Blair MP, Shapiro MJ, Lichtenstein SJ. Exudative retinopathy and detachment: a late reactivation of retinopathy of prematurity after intravitreal bevacizumab. J AAPOS. 2013;17:323–5.PubMedCrossRefGoogle Scholar
  26. 26.
    McCloskey M, Wang H, Jiang Y, Smith GW, Strange J, Hartnett ME. Anti-VEGF antibody leads to later atypical intravitreous neovascularization and activation of angiogenic pathways in a rat model of retinopathy of prematurity. Invest Ophthalmol Vis Sci. 2013;54:2020–6.PubMedCentralPubMedCrossRefGoogle Scholar
  27. 27.
    Karaca C, Oner AO, Mirza E, Polat OA, Sahiner M. Bilateral effect of unilateral bevacizumab injection in retinopathy of prematurity. JAMA Ophthalmol. 2013;131:1099–101.PubMedCrossRefGoogle Scholar

Copyright information

© Japanese Ophthalmological Society 2014

Authors and Affiliations

  • Kazuki Kuniyoshi
    • 1
    Email author
  • Koji Sugioka
    • 1
  • Hiroyuki Sakuramoto
    • 1
  • Shunji Kusaka
    • 2
  • Norihisa Wada
    • 3
  • Yoshikazu Shimomura
    • 1
  1. 1.Department of OphthalmologyKinki University Faculty of MedicineOsaka-SayamaJapan
  2. 2.Department of OphthalmologySakai Hospital, Kinki University Faculty of MedicineSakaiJapan
  3. 3.Department of PediatricsKinki University Faculty of MedicineOsaka-SayamaJapan

Personalised recommendations