الفهرس 
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Abstract
Title: Role Of Intravitreal Bevacizumab As Adjuncative Therapy in Retinopathy Of Prematurity: A
Randomized Controlled Trial
Authors: Mohamed Al-Sada, M. Sameh El-Agha, Ahmed R. Awadein, Khalid Al-Husseiny
Purpose: To determine the effect of adding intravitreal bevacizumab to conventional laser
photocoagulation in stage 3 retinopathy of prematurity (ROP)
Methods: A prospective, controlled, interventional fellow eye study in patients with bilateral stage
3 ROP necessitating bilateral laser photocagulation of non-perfused retina. Patients received diode
laser photocoagulation in one eye group (A) (LP group), and the same treatment in the fellow eye
with the addition of an intravitreal injection of bevacizumab at the end of the procedure group (B)
(LP/IVB group). The primary outcome measures were resolution of neovascularization and
occurrence of retinal detachment, and secondary outcome measures were speed of resolution of plus
disease, and the intensity of the cicatricial response.
Results: Fifteen patients met the study criteria. Seven patients had zone I disease, and 8 patients had
posterior zone II disease. All eyes (100%) in the LP/IVB group had complete resolution of
neovascularization without occurrence of retinal detachment. Out of the 15 eyes in the LP group,
12 eyes (80%) had complete resolution of neovascularization, while 3 eyes (20%) had persistent
neovascularization, which was successfully treated with intravitreal bevacizumab and supplemental
laser photocoagulation. In the latter 3 eyes, there was an exaggerated cicatricial response compared
to the fellow eye. None of the eyes in the LP group developed retinal detachment. The time from
primary intervention to resolution of plus disease ranged from 2-5 days in the (A) LP/IVB group,
and 7-10 days in the ( B ) LP group.
Conclusion: The addition of intravitreal bevacizumab (IVB) to conventional laser photocogulation
in stage 3 ROP (zones I and II) resulted in faster resolution of plus disease, more complete
resolution of neovascularization, and less need for secondary intervention, without exaggeration of
the cicatricial response. When IVB was added to supplemental laser treatment, the cicatricial
response was more intense than cases where IVB was added to the primary laser treatment, but
without the occurrence of retinal detachment. Thus IVB may be useful as an adjunct to primary
laser treatment. The late addition of IVB to supplemental laser treatment requires further study.
Key words: Retinopathy of prematurity, prematurity, ROP, Bevacizumab, Avastin, intravitreal
injection