Adjunctive effect of intravitreal bevacizumab prior to lens-sparing vitrectomy in aggressive posterior retinopathy of prematurity: a case report

Abstract

Background: Intravitreal injection of bevacizumab in retinopathy of prematurity has shown satisfactory results without any systemic complications. However, increased fibrosis and tissue contraction are reported as adverse effects in some cases.

Case: A premature girl, born at 29 weeks + 4 days of gestation, had bilateral aggressive posterior retinopathy of prematurity (APROP) on her first screening at 3 weeks of age. She received extensive, near confluent, laser ablation of the avascular retina and off-label intravitreal bevacizumab (0.75 mg) injection OU. The right eye showed a slight regression, but a localized tractional membrane was noted OS. After another intravitreal bevacizumab injection in each eye, the left eye underwent lens-sparing vitrectomy (LSV) because of contraction of the proliferative membrane leading to a dome-shaped tractional retinal detachment (TRD).

Observations: At 6-week follow-up, the left eye showed complete retinal reattachment. Both eyes showed prompt resolution of vascular engorgement with anterior progression of the peripheral retinal vasculature.

Conclusions: Intravitreal bevacizumab is safe and effective as a treatment of APROP. In some cases tissue contraction may occur, but because TRD is localized to the posterior pole, effective LSV can be performed.