Intravitreal bevacizumab for retinopathy of prematurity: refractive error results.

Purpose: To evaluate refractive error in infants who underwent intravitreal bevacizumab injection for treatment of threshold retinopathy of prematurity (ROP).

Design: Retrospective nonrandomized interventional comparative study.

Methods: The study group included all infants who consecutively received a single intravitreal bevacizumab (0.375 mg or 0.625 mg) injection for therapy of threshold ROP in fundus zone I or zone II. The control group included infants who had previously undergone retinal argon laser therapy of ROP. The follow-up examination included refractometry under cycloplegic conditions.

Results: The study group included 12 children (23 eyes; mean birth weight: 622 ± 153 g; gestational age: 25.2 ± 1.6 weeks) and the control group included 13 children (26 eyes; birth weight: 717 ± 197 g; gestational age: 25.3 ± 1.8 weeks). Both groups did not differ significantly in birth age and weight and follow-up. At the end of follow-up at 11.4 ± 2.3 months after birth, refractive error was less myopic in the study group than in the control group (-1.04 ± 4.24 diopters [median: 0 diopters] vs -4.41 ± 5.50 diopters [median: -5.50 diopters]; P = .02). Prevalence of moderate myopia (17% ± 8% vs 54% ± 10%; P = .02; OR: 0.18 [95% CI: 0.05, 0.68]) and high myopia (9% ± 6% vs 42% ± 10%; P = .01; OR: 0.13 [95% CI: 0.03, 0.67]) was significantly lower in the bevacizumab group. Refractive astigmatism was significantly lower in the study group (-1.0 ± 1.04 diopters vs 1.82 ± 1.41 diopters; P = .03). In multivariate analysis, myopic refractive error and astigmatism were significantly associated with laser therapy vs bevacizumab therapy (P = .04 and P = .02, respectively).

Conclusions: In a 1-year follow-up, a single intravitreal bevacizumab injection as compared to conventional retinal laser coagulation was helpful for therapy of ROP and led to less myopization and less astigmatism.