Michelle T Cabrera1,2, Thomas Chia3, David K Wallace4, J Niklas Ulrich5, Sharon F Freedman6,7, Leona Ding2, Kevin R Gertsch8. 1. Department of Ophthalmology, Seattle Children's Hospital, Seattle, Washington. 2. Department of Ophthalmology, University of Washington, Seattle, Washington. 3. Department of Ophthalmology, University of Southern California, Los Angeles, California. 4. Department of Ophthalmology, Indiana University, Indianapolis, Indiana. 5. Department of Ophthalmology, University of North Carolina, Chapel Hill, North Carolina. 6. Departments of Department of Ophthalmology, Duke University, Durham, North Carolina. 7. Department of Pediatrics, Duke University, Durham, North Carolina; and. 8. North Georgia Eye Clinic, Gainesville, Georgia.
Abstract
PURPOSE: To compare objectively measured changes in plus disease after bevacizumab and laser for Type 1 retinopathy of prematurity. METHODS: ROPtool (a computer program) analyzed fundus images at baseline, 1 week, and subsequent examinations. RESULTS: Six infants (9 eyes) were treated with bevacizumab and 7 (12 eyes) with laser. One week after treatment, bevacizumab compared with laser resulted in a greater median percent change from pretreatment in tortuosity (-53.8 vs. -0.2%, P < 0.001) and overall plus disease (-20.1 vs. -3.1%, P < 0.001). Change in dilation did not differ (-3.5 vs. -5.5%, P = 0.48). After week 1, all median ROPtool parameters continued to decrease for both groups. At last follow-up (median 3, range: 2-10 weeks), both bevacizumab and laser significantly decreased tortuosity (-54.3 and -23.8%), dilation (-8.7 and -7.5%), and overall plus disease (-27.3 and -10.3%). CONCLUSION: Improvement in plus disease, in particular tortuosity, likely occurs more quickly after bevacizumab compared with laser, particularly at 1 week after treatment. These results guide clinical expectations for plus disease resolution after both treatment modalities.
PURPOSE: To compare objectively measured changes in plus disease after bevacizumab and laser for Type 1 retinopathy of prematurity. METHODS: ROPtool (a computer program) analyzed fundus images at baseline, 1 week, and subsequent examinations. RESULTS: Six infants (9 eyes) were treated with bevacizumab and 7 (12 eyes) with laser. One week after treatment, bevacizumab compared with laser resulted in a greater median percent change from pretreatment in tortuosity (-53.8 vs. -0.2%, P < 0.001) and overall plus disease (-20.1 vs. -3.1%, P < 0.001). Change in dilation did not differ (-3.5 vs. -5.5%, P = 0.48). After week 1, all median ROPtool parameters continued to decrease for both groups. At last follow-up (median 3, range: 2-10 weeks), both bevacizumab and laser significantly decreased tortuosity (-54.3 and -23.8%), dilation (-8.7 and -7.5%), and overall plus disease (-27.3 and -10.3%). CONCLUSION: Improvement in plus disease, in particular tortuosity, likely occurs more quickly after bevacizumab compared with laser, particularly at 1 week after treatment. These results guide clinical expectations for plus disease resolution after both treatment modalities.