Fluorescein angiographic observations of peripheral retinal vessel growth in infants after intravitreal injection of bevacizumab as sole therapy for zone I and posterior zone II retinopathy of prematurity

Br J Ophthalmol. 2014 Apr;98(4):507-12. doi: 10.1136/bjophthalmol-2013-304109. Epub 2014 Jan 8.


Aim: To evaluate vascularisation of the peripheral retina using fluorescein angiography (FA) digital recordings of infants who had been treated with intravitreal bevacizumab (IVB) as sole therapy for zone I and posterior zone II retinopathy of prematurity (ROP).

Methods: A retrospective evaluation was performed of medical records, RetCam fundus images and RetCam fluorescein angiogram videos of 10 neonates (20 eyes) who received intravitreal bevacizumab injections as the only treatment for zone I and posterior zone II ROP between August 2007 and November 2012.

Results: All eyes had initial resolution of posterior disease after IVB injection as documented by RetCam colour fundus photographs. Using a distance of 2 disc diameters from the ora serrata to vascular termini as the upper limit of allowable avascular retina in children, the FA of these infants demonstrated that 11 of 20 eyes had not achieved normal retinal vascularisation.

Conclusions: Although bevacizumab appears effective in bringing resolution of zone I and posterior zone II ROP and allowing growth of peripheral retinal vessels, in our series of 20 eyes, complete normal peripheral retinal vascularisation was not achieved in half of the patients.

Keywords: Embryology and Development; Imaging; Neovascularisation; Retina.

Publication types

  • Case Reports

MeSH terms

  • Angiogenesis Inhibitors / therapeutic use*
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Bevacizumab
  • Capillary Permeability
  • Female
  • Fluorescein / metabolism
  • Fluorescein Angiography*
  • Gestational Age
  • Humans
  • Infant
  • Infant, Low Birth Weight
  • Infant, Newborn
  • Intravitreal Injections
  • Male
  • Retinal Neovascularization / diagnosis*
  • Retinal Vessels / pathology*
  • Retinopathy of Prematurity / classification
  • Retinopathy of Prematurity / drug therapy*
  • Retrospective Studies
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors


  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal, Humanized
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A
  • Bevacizumab
  • Fluorescein