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. 2025 Jun 20;45(1):254.
doi: 10.1007/s10792-025-03610-6.

Hemorrhagic complications in premature infants treated with intravitreal bevacizumab

Esra Kızıldağ Özbay  1 , Şenol Sabancı  2 , Mehmet Fatih Küçük  2 , Muhammet Kazım Erol  2 , Sibel Yavuz  2
Affiliations

Hemorrhagic complications in premature infants treated with intravitreal bevacizumab

Esra Kızıldağ Özbay et al. Int Ophthalmol. .

Abstract

Purpose: This study aims to evaluate the frequency of hemorrhagic complications and identify potential risk factors in premature infants treated with intravitreal bevacizumab for retinopathy of prematurity (ROP).

Methods: This retrospective study analyzed data from 132 premature infants treated with intravitreal bevacizumab for ROP. Hemorrhagic complications were categorized as preretinal or intravitreal based on clinical examination findings: preretinal hemorrhages were defined as bleeding confined to the ROP ridge and not exceeding two optic disc diameters, while intravitreal hemorrhages were defined as bleeding extending beyond two optic disc diameters into the vitreous cavity. Demographic and clinical variables, including gestational age, birth weight, maternal age, NICU length of stay, and the timing of anti-VEGF administration, were collected. Patients with pre-existing hemorrhages prior to treatment were excluded. Statistical analyses included descriptive methods, univariate comparisons, and binary logistic regression to identify independent risk factors for hemorrhagic complications.

Results: Hemorrhagic complications were observed in 23 (17.4%) of the patients, with 91.3% being preretinal hemorrhages and 8.7% intravitreal hemorrhages. NICU length of stay was significantly longer in patients with bleeding (62.23 ± 12.87 days) compared to those without bleeding (45.78 ± 16.74 days, p < 0.0001). Logistic regression identified prolonged NICU stay as an independent risk factor for hemorrhagic complications, with each additional day increasing the risk by 5.1% (p = 0.008, OR = 1.051, 95% CI 1.013-1.091). Gestational age, birth weight, maternal age, and timing of anti-VEGF administration were not significantly associated with bleeding risk.

Conclusions: This study highlights the significant role of NICU length of stay in increasing the risk of hemorrhagic complications in premature infants treated with intravitreal bevacizumab. In retinopathy. of prematurity treated with bevacizumab, preretinal and vitreous hemorrhages are common. Each additional day of NICU stay increases the risk of hemorrhagic complications.

Keywords: Hemorrhagic complications; Intravitreal bevacizumab; NICU length of stay; Preretinal hemorrhage; Retinopathy of prematurity; Risk factors.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare no competing interests. Informed consent: Verbal and written patient consent was taken in this study.

References

    1. Zin A, Gole GA (2013) Retinopathy of prematurity—incidence today. Clin Perinatol 40(2):185–200. https://doi.org/10.1016/j.clp.2013.02.001 - DOI - PubMed
    1. Lepore D, Quinn GE, Molle F et al (2021) Aflibercept, bevacizumab or ranibizumab for ROP: a comparison of efficacy and safety. Am J Ophthalmol 222:208–216. https://doi.org/10.1016/j.ajo.2020.10.030 - DOI
    1. Stahl A, Krohne TU, Eter N et al (2021) Comparison of aflibercept, bevacizumab, and ranibizumab for treatment of ROP: a randomized clinical trial. JAMA Ophthalmol 139(2):258–267. https://doi.org/10.1001/jamaophthalmol.2020.6027 - DOI
    1. Taher NO, Ghaddaf AA, Al-Ghamdi SA, Homsi JJ, Al-Harbi BJ, Alomari LK, Almarzouki HS (2022) Intravitreal anti-vascular endothelial growth factor injection for retinopathy of prematurity: a systematic review and meta-analysis. Front Med 9:884608. https://doi.org/10.3389/fmed.2022.884608 - DOI
    1. Chen J, Stahl A, Hellstrom A, Smith LE (2011) Current update on retinopathy of prematurity: screening and treatment. Curr Opin Pediatr 23(2):173–178. https://doi.org/10.1097/MOP.0b013e3283423f35 - DOI - PubMed - PMC

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