Anti-VEGF Reportedly Better than Lasers in Preventing Recurrences of Retinopathy in Prematurity

Houston, TX – Scientists at the Robert Cizik Eye Clinic at the University of Texas Health Science Center at Houston-Medical School have found that using intravitreal injections of bevacizumab are better than conventional laser therapy for the prevention of recurrences of retinopathy of prematurity (ROP). Using intravitreal injections also avoids some of the complications that come with laser treatment.

Bevacizumab, an inhibitor of vascular endothelial growth factor (VEGF), has been used more frequently as an off-label treatment for ophthalmologic neovascular disorders, such as ROP and the wet form of age-related macular degeneration.

According to the authors of the study, this is the first time a controlled trial of ROP has taken place. They picked patients who were the most vulnerable and had the worst cases of the condition. The study compared the two treatments for stage 3+ ROP in zone I or zone II. Zones indicated the area of vascularization. Zone I stage 3 is the hardest to treat, and has a higher rate of recurrence. Stage 3 ROP is when treatment usually begins, and stage 3+ means the “dilated veins and tortuous arteries” are in at least two quadrants of the eye.

The Trial

There were 15 different centers participating in the trial and used 150 infants 30 weeks old or younger. They were randomly given either intravitreal bavacizumab or conventional laser therapy. Almost 70 of the infants had zone I disease; the others had zone II posterior disease.

The primary outcome of the study was focused on recurrence, and showed 26% of the infants given laser therapy compared with only 6% of the infants given bevacizumab. The risk reduction was 83% when using bevacizumab.

The maker of bevacizumab, Genentech, does not plan to seek FDA approval for its use for treating ROP, nor will it be promoted for use for any ocular disorder.

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