Retinal Blood Flow Decreases after Treatment with Bevacizumab for Retinopathy of Prematurity.

PURPOSE: To compare total retinal blood flow (TRBF) rates before and after retinopathy of prematurity (ROP) treatment with intravitreal bevacizumab using laser speckle contrast imaging (LSCI).

DESIGN

A prospective cohort study.

PARTICIPANTS

Twenty-five eyes from 14 premature infants in the neonatal intensive care unit receiving intravitreal bevacizumab for treatment-requiring ROP.

METHODS

Total retinal blood flow was measured using LSCI longitudinally before and after bevacizumab treatment. Subject characteristics and clinical ROP features, including the need for ROP retreatment, were included in regression analysis using generalized estimating equations to account for 2 eyes per subject and longitudinal measures over time.

MAIN OUTCOME MEASURES: The main outcome measure was TRBF, which includes components of peak, mean, and dip over the cardiac cycle.

RESULTS

Before ROP treatment, subjects had a peak TRBF of 11.1 ± 2.9 a.u. compared to 8.6 ± 1.8 a.u. after treatment (mean difference = 2.5 a.u., P < 0.0001). Among eyes that required ROP retreatment earlier (<10 weeks) after initial treatment, the posttreatment peak TRBF was 9.0 ± 1.5 a.u., compared to 7.3 ± 2.2 a.u. for eyes that did not require retreatment in the first 10 weeks after initial bevacizumab injection (mean difference = 1.7 a.u., P = 0.01). Peak TRBF decreased over time after bevacizumab treatment (β = -0.1 a.u./week, P = 0.004).

CONCLUSIONS

We observed lower TRBF after treatment with intravitreal bevacizumab.

FINANCIAL DISCLOSURES: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.