Evaluation of Neurodevelopmental Outcomes in Premature Twins (Multigestations) with Retinopathy of Prematurity Receiving Anti-VEGF: A Comparison Study

Abstract

Purpose: To assess possible neurodevelopmental delay (NDD) following intravitreal antivascular endothelial growth factor (VEGF) injection in neonates with retinopathy of prematurity (ROP).

Methods: In this retrospective cohort study, neurodevelopmental milestones in patients with a history of ROP and intravitreal bevacizumab (IVB) injection were compared with other gestations that received either no treatment or only a laser for treatment.

Results: One hundred and twenty-five neonates (of 59 multi-gestation pregnancies) were included in this study (with the range of age 1-7 years old). Sixty-five (51.18%) were male and sixty-two (48.81%) were female. The mean gestational age (GA) and birth weight of all neonates were 29.69 ± 1.57 weeks (ranges: 26-33 weeks) and 1312.50 ± 269.33 grs (ranges: 730-2100 grs). None of the neurodevelopmental outcomes were statistically different when two subgroups in group A (IVB vs. control) were compared. None of the differences between IVB and laser treated subgroups is statistically significant, except for "reaching for toys," which was delayed in the laser treated subgroup (6.6 ± 2.5 and 6.9 ± 2.5 months in IVB and laser treated subgroups, respectively).

Conclusion: In neonates with ROP, there is no linear correlation between intravitreal anti-VEGF injection and neurodevelopmental delay.

Figure 1

Study flowchart.

Figure 2

The graph of neurodevelopmental milestones of neonates in two treatment type subgroups intravitreal bevacizumab vs. no treatment in (a) and intravitreal bevacizumab vs. laser in (b).