In this prospective randomized trial, researchers compared medical and developmental outcomes in infants who received bevacizumab or laser for retinopathy of prematurity (ROP).

Study design

The authors examined 16 infants who were enrolled at the Houston site in the Bevacizumab Eliminates the Angiogenic Threat of Retinopathy of Prematurity (BEAT-ROP) trial. Patients had stage 3+ ROP in zone I or zone II posterior, and were evaluated for medical and neurodevelopmental outcomes at 18 to 28 months corrected age.

Seven infants were treated with bevacizumab (0.625 mg in 0.025 ml), while 9 underwent laser therapy.

Outcomes

No medical or neurodevelopmental adverse effects were found in bevacizumab treatment group.

There was no difference in survival to discharge or discharge on oxygen between groups, but the length of hospital stay was significantly shorter in the bevacizumab group (P=0.03). The 2 groups had similar weight, length, head circumference, motor function, cerebral palsy rates, and Bayley Infant and Toddler Development scores.

Limitations

The study was not adequately powered to observe small, but clinically important differences.

Clinical significance

This randomized study showed no adverse effects from bevacizumab in terms of medical and neurodevelopmental milestones. This alleviates some of the fears among clinicians regarding the long-term impact of anti-VEGF agents on developing organs.