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Intravitreal bevacizumab to treat retinopathy of prematurity in 865 eyes: a study to determine predictors of primary treatment failure and recurrence

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Abstract

Purpose

This study aimed to evaluate the rate and risk factors for primary failure and recurrence after intravitreal anti-VEGF injection in retinopathy of prematurity (ROP).

Methods

This retrospective study was performed on 865 eyes from 441 patients with retinopathy of prematurity receiving intravitreal bevacizumab from 2012 to 2019. Medical records of patients were evaluated.

Results

Mean gestational age (GA) and birth weight of patients were 28 ± 2 weeks and 1121 ± 312 g, respectively. Thirty-five eyes (4.04%) had a primary failure, including 18 eyes from 187 eyes in zone 1 (9.6%) and 17 eyes from 678 eyes in zone 2 (2.5%). The mean time of retreatment was 16.64 ± 13.68 days in eyes without regression ROP. The remaining 830 eyes (95.95%) were included in recurrence analysis. The recurrence occurred in 33 eyes (3.97%) of them in 20 patients, with the meantime of 77.52 days after the first treatment (IVB). The presence of plus disease, history of oxygen therapy or phototherapy, and GA less than 32 were associated with significantly increased prevalence of treatment failure. The risk factors predicting recurrence are lower birth weight, zone 1 pretreatment, history of intubation, anemia, and sepsis.

Conclusion

Intravitreal anti-VEGF is a successful treatment for ROP with a low rate of primary failure and recurrence. Awareness of risk factors for treatment failure and recurrence may help clinicians to schedule more vigilant approach in susceptible cases.

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Availability of data and materials

The datasets analyzed during the current study are available from the corresponding author on reasonable request.

Code availability

Not applicable.

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Acknowledgements

Special thanks to Mehdi Yaseri PhD for data analysis.

Funding

Not applicable.

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Authors and Affiliations

  1. Eye Research Center, Farabi Eye Hospital, Retina services, Tehran University of Medical Sciences, Qazvin square, South Kargar Street, Tehran, Iran

    Kaveh Fadakar, Mohammadreza Mehrabi Bahar, Hamid Riazi-Esfahani, Afsaneh Azarkish, Afsar Dastjani Farahani, Mostafa Heidari & Fatemeh Bazvand

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  1. Kaveh Fadakar
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Contributions

FB and HRE involved in conception and design, definition of intellectual content, data acquisition, analysis and interpretation, manuscript review, and guarantor. KF and MH and MMB involved in analysis and interpretation, literature search, data acquisition, manuscript preparation, manuscript editing, and manuscript review. AA and ADF involved in definition of intellectual content, literature search and manuscript review, consistent criticism. All authors read and approved the final manuscript and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Mohammadreza Mehrabi Bahar.

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Conflict of interests

The authors declare that they have no competing interests.

Ethical approval

Human subjects were included in this study. The ethics committee of eye research center, Farabi Eye Hospital, approved this study (https://ethics.research.ac.ir/IR.TUMS.FARABI.REC.1399.040).

Consent to participate

The study was conducted according to the tenets of the Declaration of Helsinki. Any procedure was done after providing parents with informed consent.

Consent for publication

Written informed consent was obtained from the patient’s parents (that his fundus photographs were used in the Figue1) for publication of any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.

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Fadakar, K., Mehrabi Bahar, M., Riazi-Esfahani, H. et al. Intravitreal bevacizumab to treat retinopathy of prematurity in 865 eyes: a study to determine predictors of primary treatment failure and recurrence. Int Ophthalmol 42, 2017–2028 (2022). https://doi.org/10.1007/s10792-021-02198-x

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