Low Dose Bevacizumab 0.03 mg for Treatment of Type I Retinopathy of Prematurity.

Abstract

Purpose: We reviewed outcomes using intravitreal bevacizumab 0.03 mg to treat retinopathy of prematurity (ROP) after switching to this dose in November 2018.

Design: Multi-center, retrospective, non-randomized, non-masked, consecutive case series.

Methods: Results from 62 patients (123 eyes) treated between November 2018 and September 2023 with low-dose intravitreal bevacizumab, 0.03 mg in 0.03 ml, by four treating physicians were reviewed.

Main outcome measures: Primary outcome measures were percentage of eyes having initial regression of ROP and percentage of eyes that received subsequent laser treatment. Secondary outcomes were time between bevacizumab and subsequent laser treatment, number of laser spots, and percentage with recurrence of ROP.

Results: All eyes had initial regression of ROP. Of the 123 eyes, 42 (34%) received laser treatment at some point after bevacizumab; 34 (28%) for persistent avascular retina (PAR) and 8 (7%) for reactivation of ROP. The average time between bevacizumab and laser was 16 ± 6 weeks for PAR and 13 ± 5.8 weeks for recurrent ROP. The mean number of laser spots per eye was 496 ± 247 for PAR and 905 ± 915 for recurrent ROP (p = 0.028). No eyes developed stage 4 or stage 5 ROP.

Conclusion: Based on historical comparisons, a 0.03-mg dose of intravitreal bevacizumab was as effective as a 0.625-mg dose for treatment of ROP. These data provide additional evidence from clinical practice to support the use of a 0.03-mg dose of bevacizumab for treatment of ROP.