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Background <p>This study aimed to evaluate the incidence and risk factors of reactivation following intravitreal bevacizumab (IVB) treatment for retinopathy of prematurity (ROP) and to determine which cases required additional treatment.</p> Methods <p>A retrospective cohort study was conducted including 62 premature infants (119 eyes) diagnosed with type 1 ROP or aggressive ROP (A-ROP) who received IVB monotherapy between September 2021 and July 2024. Demographic and clinical parameters such as gestational age, birth weight, disease zone and stage, duration of oxygen therapy, and timing of IVB administration were analyzed. Reactivation and retreatment rates were compared to identify potential risk factors.</p> Results <p>Reactivation occurred in 36 eyes (30.3%), and 31 of these eyes (86.1%) required additional treatment. The mean gestational age and birth weight in reactivated eyes were 24.4 ± 1.2 weeks and 643 ± 149&#xa0;g, respectively. Reactivation was significantly associated with lower gestational age (<i>p</i> &lt; 0.001), lower birth weight (<i>p</i> &lt; 0.001), longer pre- and post-IVB oxygen therapy (<i>p</i> = 0.006 and <i>p</i> &lt; 0.001), zone 1 disease (<i>p</i> &lt; 0.001), and the presence of A-ROP (<i>p</i> &lt; 0.001). Reactivation developed on average 9.4 weeks after IVB administration. Female infants showed a higher proportion of treatment-requiring reactivation (<i>p</i> = 0.031).</p> Conclusions <p>Reactivation following IVB therapy is common among infants with low gestational age, low birth weight, prolonged oxygen exposure, and aggressive or zone 1 disease. Although most reactivations required retreatment, some resolved spontaneously, highlighting the importance of individualized and extended post-treatment monitoring.</p>

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Reactivation of retinopathy of prematurity after intravitreal bevacizumab: incidence, risk factors, and retreatment requirements

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月19日

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  • Cengiz Gül,
  • Ece Özal,
  • Serhat Ermiş,
  • Murat Karapapak,
  • Havvanur Bayraktar,
  • Sadık Altan Özal

摘要

Background

This study aimed to evaluate the incidence and risk factors of reactivation following intravitreal bevacizumab (IVB) treatment for retinopathy of prematurity (ROP) and to determine which cases required additional treatment.

Methods

A retrospective cohort study was conducted including 62 premature infants (119 eyes) diagnosed with type 1 ROP or aggressive ROP (A-ROP) who received IVB monotherapy between September 2021 and July 2024. Demographic and clinical parameters such as gestational age, birth weight, disease zone and stage, duration of oxygen therapy, and timing of IVB administration were analyzed. Reactivation and retreatment rates were compared to identify potential risk factors.

Results

Reactivation occurred in 36 eyes (30.3%), and 31 of these eyes (86.1%) required additional treatment. The mean gestational age and birth weight in reactivated eyes were 24.4 ± 1.2 weeks and 643 ± 149 g, respectively. Reactivation was significantly associated with lower gestational age (p < 0.001), lower birth weight (p < 0.001), longer pre- and post-IVB oxygen therapy (p = 0.006 and p < 0.001), zone 1 disease (p < 0.001), and the presence of A-ROP (p < 0.001). Reactivation developed on average 9.4 weeks after IVB administration. Female infants showed a higher proportion of treatment-requiring reactivation (p = 0.031).

Conclusions

Reactivation following IVB therapy is common among infants with low gestational age, low birth weight, prolonged oxygen exposure, and aggressive or zone 1 disease. Although most reactivations required retreatment, some resolved spontaneously, highlighting the importance of individualized and extended post-treatment monitoring.