Bevacizumab shows efficacy for resolving severe ROP, surgeon says

BANGALORE, India — When used appropriately, bevacizumab can produce remarkable results in infants with severe retinopathy of prematurity, according to a surgeon speaking here.

"Our study shows that it is a safe and expedient procedure," said Alay S. Banker, MD, at a free paper session at the All India Ophthalmological Society.

Dr. Banker presented results from 14 eyes of nine infants with severe ROP who received one injection of 0.75 mg of Avastin (bevacizumab, Genentech). The infants had a mean birth weight of 1,133 g and a mean gestation period of 29.2 weeks; they were treated at a mean age of 2.3 months.

Follow-up ranged from 3 months to 12 months. Eight eyes had previously received laser treatment and six eyes received bevacizumab as a first-line treatment.

Dr. Banker said that bevacizumab produced "excellent, remarkable results."

All eyes fully recovered, with rubeosis disappearing within 2 days of treatment. No eyes required repeated treatments or experienced complications, Dr. Banker said.

"The timing of anti-VEGF treatment is very important," he explained, because later phases of ROP have higher VEGF levels than those of early-stage patients.

Dr. Banker said, in theory, a pan-VEGF blocker such as bevacizumab may not be the ideal treatment, and studies should be conducted to evaluate selective VEGF blockers, such as Macugen (pegaptanib sodium, OSI Eyetech/Pfizer). This study, he said, used bevacizumab because of its availability and cost-effectiveness.

In addition, Dr. Banker said bevacizumab might be a good option for first-line treatment because facilities in areas throughout India may not have laser or cryotherapy treatment options. Also, bevacizumab is a relatively easy and inexpensive treatment, he said.