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.

Click here to read the abstract and access the full article for a fee.




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7 Responses to “Is a Single Intravitreal Injection of Avastin More Effective Than Lasers in Treating Retinopathy of Prematurity?”

  • ari

    his rop is too far advanced for injection- the retina is already off

  • nermin

    Is avastin effective only for certain stages for ROP e.g. 1,2,3 only ?
    Is avastin more effective as early intervention for premature babies with ROP or can my 5 years old who have stage 4B ROP benefit from it at his age?

  • MIchelle Hurter

    My daughter, born at 25 weeks in May 2006, received Astavin injections for ROP. Her vision continues to improve every time we visit the opthamologist and the retina consultants. We believe this is a miracle drug for premature babies with ROP.

  • Nadia

    i have a son in 2 years old he is totaly blind beacuse of ROP. can avastin be benefit för him? or its late to treat with Avastin injektion?

  • I have just written an extensive overview of the NEJM writeup on this subject:

    Avastin/Lucentis Update 45: Avastin Drug Treatment for ROP Better than Laser

    A new study, published earlier this month in the New England Journal of Medicine, describes the use of intravitreal Avastin to treat Retinopathy of Prematurity (ROP) in premature infants.
    In the study, Avastin was used to treat preemies with uncontrolled growth of blood vessels rather than using laser treatments that can cause permanent damage. Avastin was used rather than Lucentis because of its larger molecular size limiting its travel outside of the eye – and also because of the cost differential.

    This treatment should become the treatment of choice in the future.

    For more on this study, please see:

  • ari

    Perhaps Avastin should be the new standard of care.

  • Maria Ana Martinez-Castellanos

    We have been working with avastin and retinopathy of prematurity since 2005, since then we have not applied any laser, after 219 patients treated we believe that this treatment move us closer to a better treatment that is accessible, cheap, small learning curve, the same or better results than conventional laser treatment, less complications reported than with previous laser treatment.