Intravitreal bevacizumab in the treatment of retinopathy of prematurity: a literature review
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Abstract
Introduction: Retinopathy of prematurity is a vascular disorder typical of the immature retina of premature children, and a leading cause of childhood blindness. In the last years, new therapeutic approaches to the disease are gaining popularity, especially the anti-angiogenesis therapy with bevacizumab. Objective: To review the literature about the use of bevacizumab in the treatment of retinopathy of prematurity, focusing on its efficiency, harmful effects and dosage. Data source: PubMed, Medline, Lilacs and SciElo databases in the last 15 years, using the descriptors “bevacizumab”, “retinopathy of prematurity” and “angiogenesis inhibitors” in
Portuguese, English and Spanish languages, as well as guideline texts. Data synthesis: Many studies have shown the efficiency of this drug in the treatment of premature’s retinopathy, with similar or even better outcomes compared to standard approach (laser). However, the methodological quality is almost always low and many other articles point out several ocular and systemic harmful effects, due to the angiogenesis inhibitor mechanism of this medicine, still not well studied. Positive results with even smaller doses bring hope of an effective and safe treatment. Conclusions: Bevacizumab should not be used as a first option to treat retinopathy of prematurity until rigorous randomized clinical trials certifying its safety, efficiency and adequate therapeutic plan are conducted. Its use should be considered in selected cases, such as more aggressive forms of the disease, refractory to laser photocoagulation.
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