Pulmonary function in school-age children following intravitreal injection of bevacizumab for retinopathy of prematurity

Abstract

The effect of anti-vascular endothelial growth factor on neonatal lung development was inconclusive. To evaluate pulmonary function in school-age children who have received intravitreal bevacizumab (IVB) for retinopathy of prematurity (ROP), this study included 118 school-aged children who were grouped into three groups: full-term control children (group 1), preterm children who had not received IVB treatment (group 2) and preterm children with ROP who had received IVB treatment (group 3). Pulmonary function was measured by spirometry and impulse oscillometry. Pulmonary function was significantly better in group 1 than in groups 2 and 3 (all p < 0.05 in forced vital capacity (FVC), forced expiratory volume in 1 s (FEV₁), forced expiratory flow between 25 and 75% of FVC (FEF_25-75), and respiratory resistance at 5 Hz and difference between respiratory resistance at 5 and 20 Hz (R5-R20). There were no statistically significant differences between group 2 and group 3 in all pulmonary function parameters, including FVC, FEV₁, ratio of FEV₁ to FVC, FEF_25-75, R5, R20, R5-R20, and respiratory reactance at 5 Hz. In conclusion, our study revealed that preterm infants receiving IVB for ROP had comparable pulmonary function at school age to their preterm peers who had not received IVB treatment.

Figure 1

Flowchart showing the inclusion and exclusion of patients during the study period. Abbreviations: IVB, intravitreal injection of bevacizumab; ROP, retinopathy of prematurity. ^aFull-term children were matched to groups 2 and 3 by age at pulmonary function testing. ^bOne patient received IVB in the right eye and laser treatment in the left eye. ^cOne patient received IVB in the right eye and combined IVB and laser treatment in the left eye.