Intravitreal injection of bevacizumab (avastin) for treatment of stage 3 retinopathy of prematurity in zone I or posterior zone II.

Purpose: To report a retrospective, consecutive, noncomparative case series of moderate and severe stage 3 retinopathy of prematurity (ROP) in zone I or posterior zone II treated by bilateral intravitreal injections of bevacizumab (Avastin; Genentech, Inc., South San Francisco, CA).

Methods: Eleven infants weighing from 515 g to 1,015 g at birth (mean, 706.4 g) with gestational ages from 23 weeks to 28 weeks (mean, 24.3 weeks) received intravitreal injections of bevacizumab (0.625 mg [0.025 mL]) at 9.0 weeks to 15.0 weeks of age (mean, 11.0 weeks) and never had laser therapy. Length of follow-up was from 13.0 weeks to 85.0 weeks (mean, 48.5 weeks). RetCam photography (Clarity Medical Systems, Pleasanton, CA) was used to document preinjection retinal appearance and to follow postinjection retinal appearance.

Results: All 22 eyes were treated successfully (no retinal detachment, macular ectopia, high myopia, anisometropia, or other ocular abnormalities) with only 1 injection. No complications (local or systemic) were encountered.

Conclusions: Intravitreal injection of bevacizumab was safe and effective in treating stage 3 ROP in zone I and posterior zone II in this small series of patients. A prospective, randomized, controlled, multicenter clinical trial has been initiated to investigate further this promising treatment.