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Objectives:

To report the ocular outcome in retrospective consecutive case series of Type I ROP (stage 3+) who had intravitreal injection of avastin as treatment for acute ROP.

Methods:

Retrospective review of 32 premature infants clinical cases (50 eyes) who received 0,03 cc of intravitreal bevacizumab as adjuvant treatment for laser ablation or as primary treatment for Type 1 ROP (stage 3+) between February 2006 and March 2014. Six infants (10 eyes) from 23 to 28 weeks of gestational age (mean 25,9 weeks) received intravitreal bevacizumab as a combined rescue treatment for progressive ROP after peripheral laser ablation and 26 infants (40 eyes) from 23 to 29,6 weeks of gestational age (mean 14,8 weeks) received intravitreal injection of bevacizumab as a primary treatment. Fourteen infants received bilateral treatment and eleven infants unilateral treatments. Twenty-six eyes had Zone I ROP, sixteen eyes Posterior Zone II ROP and eight eyes Zone II ROP.

Results:

Forty-six eyes (30 infants) had complete regression of acute ROP either with primary or combined treatment with no local or systemic apparent complications. In some eyes we could find a sub-conjunctival hemorrhage at the injection site, but we did not consider this event as a complication. In two eyes (1 infant) it was necessary to perform a second bilateral injection at month 3 and one of the eyes had a late relapse (month 12) with progressive stage IV (retina successfully attached after lens sparing vitrectomy). In two eyes (1 infant) ablation of avascular peripheral retina was performed at month 5 because of ROP recurrence. All eyes with Zone I ROP and Posterior Zone II ROP who had laser ablation developed high myopia in opposition to eyes that had intravitreal injection of bevacizumab as primary treatment.

Conclusion:

Intravitreal injection of bevacizumab seems to be effective and safe in Type 1 (stage 3+) ROP as a primary or as a combined treatment. Dose, timing and follow-up visits need additional research.