Neurodevelopmental outcomes following intravitreal bevacizumab injection in Japanese preterm infants with type 1 retinopathy of prematurity

PLoS One. 2020 Mar 20;15(3):e0230678. doi: 10.1371/journal.pone.0230678. eCollection 2020.

Abstract

Purpose: The purpose of this study was to evaluate neurodevelopmental outcomes in 18-month old (corrected age) preterm infants who received an intravitreal bevacizumab (IVB) injection for the treatment of type 1 retinopathy of prematurity (ROP).

Methods: In this ten-year retrospective study, we reviewed the medical records of patients who underwent ROP screening at Kyushu University Hospital. Among the patients who received IVB or laser photocoagulation (LPC) for the treatment of type 1 ROP, we included infants whose neurodevelopmental examination (the Kyoto Scale of Psychological Development [KSPD]) results at 18 months corrected age were available. Then, the effect of IVB on the developmental quotient (DQ) in each KSPD domain (Postural-Movement, Cognitive-Adaptive, or Language-Social domain) or the overall DQ was investigated by performing linear regression analysis.

Results: Out of the 513 patients reviewed, 53 were included in the study. IVB and LPC were performed for 14 and 39 patients, respectively. Administration of IVB was significantly associated with neurodevelopmental delay in the Language-Social domain (p = 0.01). The observed association remained even after adjusting for gestational age and birth weight (p = 0.03).

Conclusions: Administration of IVB may introduce a risk of developmental impairment of interpersonal relationships, socializations, and/or verbal abilities of preterm children. We recommended that preterm infants who received IVB undergo a neurodevelopmental reassessment during their school years or in adulthood.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Angiogenesis Inhibitors / adverse effects*
  • Angiogenesis Inhibitors / therapeutic use
  • Bevacizumab / adverse effects*
  • Bevacizumab / therapeutic use
  • Developmental Disabilities / etiology*
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Intravitreal Injections
  • Japan
  • Language Development Disorders / etiology
  • Laser Coagulation
  • Multivariate Analysis
  • Retinopathy of Prematurity / drug therapy
  • Retinopathy of Prematurity / pathology*
  • Retinopathy of Prematurity / surgery
  • Retrospective Studies
  • Severity of Illness Index

Substances

  • Angiogenesis Inhibitors
  • Bevacizumab

Grants and funding

This work was funded by a JSPS KAKENHI Grant Number JP19K18846 for M.Arima (https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-19K18846/). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.