Intravitreal Injection Of Bevacizumab For Aggressive Posterior Retinopathy Of Prematurity
1. Yulia Aziza¹
2. Ari Djatikusumo¹
3. Julie D Barliana¹
4. Lumongga Simangunsong¹
5. Rita S Sitorus¹
¹Department of Ophthalmology, Medical Faculty of University of Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
Purpose: To present the result of Bevacizumab intravitreal injection in a case of aggressive posterior retinopathy of prematurity (AP-ROP) at Cipto Mangunkusumo Hospital.
Methods: A premature baby (34 weeks gestation, birth weight 1500 g) was referred to our hospital at 37 weeks gestational age with the diagnosis of ROP stage 3 zone I with plus disease on both eyes. Our examination revealed vitreous and retinal hemorrhage with peripapillary hemorrhage which indicates AP-ROP on both eyes. Laser photocoagulation combined with Bevacizumab intravitreal injection 0,75 mg in 0,025cc was performed on both eyes. Systemic complication during and after injection were evaluated.
Results: Examination on 1 week after Bevacizumab intravitreal injection showed partial regression of retinal hemorrhage. Due to the poor systemic condition (sepsis and intraventricular hemorrhage grade 2), serial follow up examination was postponed until 3 weeks after injection which showed the development of partial retinal detachment. Neither additional laser photocoagulation nor surgical treatment was done because of the poor general condition. On the last follow up (5 weeks after injection) funduscopic examination of both eyes revealed total retinal detachment.
Conclusions: Several factors might influence the outcomes of Bevacizumab intravitreal injection in AP-ROP such as the disease stage at the first treatment, the presence of associated ROP risk factors, the optimal dose and administration. Septicemia and intraventricular hemorrhage should be considered as associated factors that influence the poor result of intravitreal Bevacizumab injection.
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