Is a Single Intravitreal Injection of Avastin More Effective Than Lasers in Treating Retinopathy of Prematurity?
February 22, 2011
The latest issue of the New England Journal of Medicine reported on a study investigating the efficacy of intravitreal bevacizumab (Avastin) for stage 3+ retinopathy of prematurity.
The abstract notes that peripheral retinal ablation with conventional (confluent) laser therapy is destructive, causes complications, and does not prevent all vision loss, especially in cases of retinopathy of prematurity affecting zone I of the eye.
The study consisted of a prospective, controlled, randomized, multicenter trial to assess intravitreal injection of Avastin (bevacizumab) for zone I or zone II posterior stage 3+ (i.e., stage 3 with plus disease) retinopathy of prematurity. Infants were randomly assigned to receive intravitreal bevacizumab (0.625 mg in 0.025 ml of solution) or conventional laser therapy, bilaterally. The primary ocular outcome was recurrence of retinopathy of prematurity in one or both eyes requiring retreatment before 54 weeks’ postmenstrual age.
The results showed a strong benefit from intravitreal injection of Avastin (bevacizumab) as compared with conventional laser therapy in infants with stage 3+ retinopathy of prematurity insofar as injection therapy had a recurrence rate in combined retinal zones I and II of 6% compared with a 26% recurrence rate in with laser treatment.
Other advantages of Avastin injection in treating retinopathy of prematurity are that the drug is inexpensive and can be administered bedside, while laser therapy requires special equipment and facilities, as well as sedation and intubation. Conventional laser therapy also often damages infants’ peripheral vision.
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