Experience with intravitreous Bevacizumab for treatment of Aggressive Posterior Retinopathy of Prematurity (AP-ROP)

1. Usa Thitiratsanont, MD¹
2. Benjawan Wutthiworawong, MD¹
3. Chairat Saovaprut, MD²

¹Department of Ophthalmology, Queen Sirikit National Institute of Child health, Bangkok, Thailand
²Department of Ophthalmology, Rajavithi Hospital, Bangkok, Thailand

Purpose : To assess a new method─ the "Combine Treatment"─ for treatment of APROP

Methods : Eleven premature infants (6 Male, 5 Female) from ROP clinic with diagnosis aggressive posterior retinopathy of prematurity (AP-ROP) based on indirect ophthalmoscopic examination were included in this study. The "Combine Treatment" consisted of one treatment session in which laser photocoagulation was applied in the avascular zone (anterior and posterior to the presumed ridge include vascular nets up to the clear retina) followed by intravitreal injection of Bevacizumab (Avastin). Fundus photographs were obtained before and after the treatment using a wide-field digital pediatric imaging system (RetCam).

Results : Eighteen out of twenty-two eyes were treated with the "Combine Treatment". The rest was treated with only laser abrasion. Only eight (15 eyes) patients were follow up in our clinic and they got favorable anatomical outcomes of all treated eyes. Proliferative tissue regressed 14 days after treatment. There was neither progression of disease nor serious ocular or systemic complications. No further treatments were needed.

Conclusions : The one session of the "Combine Treatment" leads to favorable anatomical outcomes for patients with AP-ROP. We hope that new approach is another choice of treatment to prevent aggressive progression of the disease and gain good vision in the future.