Combine intravitreal bevacizumab injection with laser treatment for aggressive posterior retinopathy of prematurity (AP-ROP).

OBJECTIVE: To assess a new method the "Combine Treatment" consisted of diode laser photocoagulation and intravitreal bevacizumab for treatment of AP-ROP.

MATERIAL AND METHOD: These retrospective and non-comparative case series study in twelve premature infants (7 Male, 5 Female) from ROP clinic with diagnosis of aggressive posterior retinopathy of prematurity (AP-ROP) based on indirect ophthalmoscopic examination were included in the present study. The "Combine Treatment" consisted of one treatment session in which diode laser photocoagulation was applied in the avascular zone (anterior and posterior to the presumed ridge include vascular nets up to the clear retina) followed by intravitreal injection of Bevacizumab (Avastin). Fundus photographs were obtained before and after the treatment using a wide-field digital pediatric imaging system (RetCam).

RESULTS: Twenty-three eyes were treated with the "Combine Treatment". The rest were treated with only laser abrasion. All patients got favorable anatomical outcomes of all treated eyes. Proliferative tissue started regress 2 weeks after treatment and completed regress about 4.92 weeks (range; 3-7 weeks). There was neither progression of disease nor serious ocular or systemic complications. No further treatments were needed.

CONCLUSION: In the present study, one session of the "Combine Treatment" leads to favorable anatomical outcomes for patients with AP-ROP. This new approach prevents aggressive progression and offers hope of good future vision to patients. The authors hope that this new approach will be another choice of treatment to prevent aggressive progression of the disease and gain good vision in the future.