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Neurodevelopmental outcomes in infants treated with intravitreal bevacizumab versus laser

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Abstract

Objective

To compare neurodevelopmental and visual outcomes in preterm infants treated with intravitreal bevacizumab (IVB) to laser ablation at 18–24 months corrected age.

Study design

A retrospective study was performed. The primary outcome was neurodevelopmental impairment (NDI). Secondary neurodevelopmental outcomes were significant NDI (sNDI), cerebral palsy, hearing loss, and composite scores of the Bayley Scales of Infant Development, Third edition. Visual outcomes included structural and refractive outcomes. Adjusted odds ratios (AOR) were calculated controlling for GA, sex, and ROP severity and confounding baseline characteristics using a cutoff of p < 0.20.

Results

Thirty-four (60 eyes) infants receiving IVB and 30 (51 eyes) laser were included. No significant differences were identified in NDI (AOR 1.77, 95% CI 0.46, 6.73) or sNDI (AOR 2.31, 95% CI 0.75, 7.14). There were no other differences in outcomes.

Conclusions

Larger randomized trials are required to establish long-term efficacy and safety of IVB in preterm neonates.

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Acknowledgements

The authors gratefully acknowledge all site investigators of the Canadian Neonatal Network (CNN) and Canadian Neonatal Follow-Up Network (CNFUN). We would also like to extend our thanks to the data abstractors of the CNN and CNFUN at three participating hospitals, as well as the staff at the Maternal-Infant Care Research Centre at Mount Sinai Hospital, Toronto, ON for providing organizational support for this project.

Funding source

Although no specific funding has been received for this study, organizational support for the Canadian Neonatal Network was provided by the Maternal-Infant Care Research Centre (MiCare) at Mount Sinai Hospital in Toronto. MiCare and the Canadian Neonatal Follow-Up Network are supported by a Canadian Institutes of Health Research (CIHR) Team Grant (FRN87518) and in-kind support from Mount Sinai Hospital. PSS holds an Applied Research Chair in Reproductive and Child Health Services and Policy Research awarded by the CIHR (APR-126340). The funding agencies had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Author information

Author notes

  1. These authors contributed equally: Kamini Raghuram, Maram Isaac

Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, University of Toronto, Toronto, ON, Canada

    Kamini Raghuram

  2. Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, ON, Canada

    Maram Isaac, Kamiar Mireskandari & Nasrin Tehrani

  3. Department of Pediatrics, Mount Sinai Hospital, Toronto, ON, Canada

    Junmin Yang, Edmond Kelly & Prakesh S. Shah

  4. Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada

    Alaa AlAli, Kamiar Mireskandari & Nasrin Tehrani

  5. Division of Neonatology Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada

    Linh G. Ly

  6. Department of Paediatrics, University of Toronto, Toronto, ON, Canada

    Linh G. Ly, Edmond Kelly, Rudaina Banihani & Prakesh S. Shah

  7. Department of Newborn and Developmental Paediatrics, Sunnybrook Health Sciences Centre, Toronto, ON, Canada

    Rudaina Banihani

  8. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada

    Prakesh S. Shah

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  1. Kamini Raghuram
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Contributions

MI and KR contributed to conceptualizing the study and designed the study, drafted the initial manuscript, and approved the final manuscript as submitted. JY carried out the initial analyses, reviewed and revised the manuscript, and approved the final manuscript as submitted. AAA contributed to data collected, aided in formulating the study proposal, reviewed and revised the manuscript, and approved the final manuscript as submitted. KM contributed to the concept, design and interpretation of data, critically reviewed and revised the draft manuscript for intellectual content, and approved the final submitted version of the article. LGL, EK, and RB oversaw and interpreted all the developmental assessments at their respective institutions, reviewed and critically revised the manuscript, and approved the final manuscript as submitted. PSS reviewed the initial study proposal and research ethics application, contributed to the concept of the study, acquisition, analysis and interpretation of data, reviewed and critically revised the manuscript, and approved the final manuscript as submitted. NT proposed the research question, conceptualized the study, reviewed the initial study proposal and research ethics application, contributed to the acquisition, analysis and interpretation of data, reviewed and critically revised the manuscript, and approved the final manuscript as submitted. All authors approved the final manuscript as submitted and agreed to be accountable for all aspects of the work.

Corresponding author

Correspondence to Nasrin Tehrani.

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Raghuram, K., Isaac, M., Yang, J. et al. Neurodevelopmental outcomes in infants treated with intravitreal bevacizumab versus laser. J Perinatol 39, 1300–1308 (2019). https://doi.org/10.1038/s41372-019-0420-z

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