Retinopathy of prematurity (ROP) is a retinal vascular developmental disorder and the leading cause of infant blindness in developed countries.1 Although laser photocoagulation is the gold standard therapy for the management of ROP, it permanently reduces the visual field and might induce myopia with some other rare complications. Off-label use of anti–vascular endothelial growth factor (VEGF) therapy in the form of bevacizumab has recently become popular; however, the ideal dose, adverse effects, and effect on mortality rates remain undetermined.2 Herein, we examined 4 patients with stage 3 ROP (Table) who were treated with a unilateral bevacizumab injection using a sequential laser and showed bilateral regression of ROP. Our findings indicate the systemic escape of bevacizumab from the injected eye and the achievement of significant blood concentrations, which can reduce vascular activity in the contralateral untreated eye.
Karaca C, Oner AO, Mirza E, Polat OA, Sahiner M. Bilateral Effect of Unilateral Bevacizumab Injection in Retinopathy of Prematurity. JAMA Ophthalmol. 2013;131(8):1099-1101. doi:10.1001/jamaophthalmol.2013.400