Zhang David L, Yoon Hawke H, deRegnier Raye-Ann O, Arzu Jennifer, Rahmani Safa
Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Division of Ophthalmology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
Clin Ophthalmol. 2022 Aug 20;16:2713-2722. doi: 10.2147/OPTH.S378520. eCollection 2022.
To investigate the postnatal growth and neurodevelopment of infants with retinopathy of prematurity (ROP) treated with intravitreal bevacizumab (IVB).
This was a retrospective comparative study. A total of 262 infants were divided among three study groups: 22 treated with intravitreal bevacizumab, 55 treated with laser, and 185 with ROP that resolved without treatment. Infants with nonviable course or hydrocephalus, a source of non-physiologic weight gain, were excluded. Neurodevelopment was assessed with Bayley III scores at 17-28 months if available and presence of hearing loss or cerebral palsy. Weekly weight, height, and head circumference from birth through 50 weeks postmenstrual age (PMA) were modeled to determine differences in growth trajectories following treatment.
Comparison of postnatal growth curves from the time of treatment to 50 weeks PMA showed no significant differences in growth trajectories between groups after adjusting for the corresponding growth parameters at birth. Comparison of Bayley scores in patients with available data (n = 120) showed no significant differences. There was an increased risk of cerebral palsy in the IVB group after logistic regression adjusting for baseline confounders, but this did not retain statistical significance after applying the false discovery rate correction for multiple testing.
To our knowledge, this is the first large retrospective study to examine longitudinal growth in infants treated with IVB compared to controls. There were no significant differences in postnatal growth or neurodevelopmental outcomes between groups, which overall continue to support the safety of bevacizumab treatment for ROP.
研究玻璃体内注射贝伐单抗（IVB）治疗早产儿视网膜病变（ROP）患儿的出生后生长及神经发育情况。
这是一项回顾性比较研究。总共262例婴儿被分为三个研究组：22例接受玻璃体内注射贝伐单抗治疗，55例接受激光治疗，185例ROP患儿未经治疗自行缓解。排除病情不可逆转或患有脑积水（非生理性体重增加的一个原因）的婴儿。若条件允许，在17至28个月时用贝利婴幼儿发展量表第三版（Bayley III）评分评估神经发育情况，并评估是否存在听力损失或脑瘫。对从出生至月经龄（PMA）50周的每周体重、身高和头围进行建模，以确定治疗后生长轨迹的差异。
从治疗时到PMA 50周的出生后生长曲线比较显示，在对出生时相应生长参数进行校正后，各组间生长轨迹无显著差异。对有可用数据的患者（n = 120）的贝利评分比较显示无显著差异。在对基线混杂因素进行逻辑回归调整后，IVB组脑瘫风险增加，但在应用多重检验的错误发现率校正后，这一结果未保留统计学意义。
据我们所知，这是第一项大型回顾性研究，比较了接受IVB治疗的婴儿与对照组婴儿的纵向生长情况。各组间出生后生长或神经发育结局无显著差异，总体上继续支持贝伐单抗治疗ROP的安全性。
