[Off-label use of intravitreal bevacizumab for severe retinopathy of prematurity].

Abstract

OBJECTIVE:

To examine the quality of evidence and the variability in the off-label use of intravitreal bevacizumab for retinopathy of prematurity (ROP).

METHODS:

A wide review of the literature was performed using Pubmed, Medline, and Cochrane database, using the words vascular endothelial growth factor (VEGF), retinopathy of prematurity, treatment and bevacizumab.

RESULTS:

Case reports, case series, reviews, one sistematic review and one randomized controlled trial were found on the use of intravitreal bevacizumab in severe ROP, as monotherapy or combined with láser and/or vitrectomy.

CONCLUSIONS:

The results shown on the use of intravitreal bevacizumab in ROP stage 3+ in zone I or in aggressive posterior ROP are promising. However, uncertainty remains regarding its maximum tolerable dose in the neonatal group, its ocular and systemic safety profile, or its efficacy and bioactivity in a developing child. This report found no significant differences in the recurrence rates of ROP stage 3+ in zone II in patients treated with intravitreal bevacizumab monotherapy in comparison to láser, although the latter is the best option due to long-term safety and efficacy. The use of intravitreal bevacizumab is not indicated in stages 1 and 2 of ROP as the risk of severe visual loss is low and VEFG is necessary for normal retinal vessel development. On the other hand, the use of intravitreal bevacizumab would be contraindicated in stages 4 and 5 because the retinal detachment is accelerated.

• Authors: L E Alba, R A Zaldua, R A Masini
• Journal: Archivos de la Sociedad Espanola de Oftalmologia (Arch Soc Esp Oftalmol) Vol. 90 Issue 2 Pg. 81-6 (Feb 2015) ISSN: 1989-7286 [Electronic] Spain
• Vernacular Title: Uso off-label de bevacizumab intravítreo en retinopatía del prematuro severa.
• PMID: 25459682 (Publication Type: Journal Article, Review)
• Copyright: Copyright © 2011 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

Chemical References

• Angiogenesis Inhibitors
• Bevacizumab

Topics

• Angiogenesis Inhibitors (therapeutic use)
• Bevacizumab (therapeutic use)
• Humans
• Off-Label Use
• Retinopathy of Prematurity (drug therapy)
• Severity of Illness Index