Abstract
Objective
To compare neurodevelopmental and visual outcomes in preterm infants treated with intravitreal bevacizumab (IVB) to laser ablation at 18ā24 months corrected age.
Study design
A retrospective study was performed. The primary outcome was neurodevelopmental impairment (NDI). Secondary neurodevelopmental outcomes were significant NDI (sNDI), cerebral palsy, hearing loss, and composite scores of the Bayley Scales of Infant Development, Third edition. Visual outcomes included structural and refractive outcomes. Adjusted odds ratios (AOR) were calculated controlling for GA, sex, and ROP severity and confounding baseline characteristics using a cutoff of pā<ā0.20.
Results
Thirty-four (60 eyes) infants receiving IVB and 30 (51 eyes) laser were included. No significant differences were identified in NDI (AOR 1.77, 95% CI 0.46, 6.73) or sNDI (AOR 2.31, 95% CI 0.75, 7.14). There were no other differences in outcomes.
Conclusions
Larger randomized trials are required to establish long-term efficacy and safety of IVB in preterm neonates.
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Acknowledgements
The authors gratefully acknowledge all site investigators of the Canadian Neonatal Network (CNN) and Canadian Neonatal Follow-Up Network (CNFUN). We would also like to extend our thanks to the data abstractors of the CNN and CNFUN at three participating hospitals, as well as the staff at the Maternal-Infant Care Research Centre at Mount Sinai Hospital, Toronto, ON for providing organizational support for this project.
Funding source
Although no specific funding has been received for this study, organizational support for the Canadian Neonatal Network was provided by the Maternal-Infant Care Research Centre (MiCare) at Mount Sinai Hospital in Toronto. MiCare and the Canadian Neonatal Follow-Up Network are supported by a Canadian Institutes of Health Research (CIHR) Team Grant (FRN87518) and in-kind support from Mount Sinai Hospital. PSS holds an Applied Research Chair in Reproductive and Child Health Services and Policy Research awarded by the CIHR (APR-126340). The funding agencies had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
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MI and KR contributed to conceptualizing the study and designed the study, drafted the initial manuscript, and approved the final manuscript as submitted. JY carried out the initial analyses, reviewed and revised the manuscript, and approved the final manuscript as submitted. AAA contributed to data collected, aided in formulating the study proposal, reviewed and revised the manuscript, and approved the final manuscript as submitted. KM contributed to the concept, design and interpretation of data, critically reviewed and revised the draft manuscript for intellectual content, and approved the final submitted version of the article. LGL, EK, and RB oversaw and interpreted all the developmental assessments at their respective institutions, reviewed and critically revised the manuscript, and approved the final manuscript as submitted. PSS reviewed the initial study proposal and research ethics application, contributed to the concept of the study, acquisition, analysis and interpretation of data, reviewed and critically revised the manuscript, and approved the final manuscript as submitted. NT proposed the research question, conceptualized the study, reviewed the initial study proposal and research ethics application, contributed to the acquisition, analysis and interpretation of data, reviewed and critically revised the manuscript, and approved the final manuscript as submitted. All authors approved the final manuscript as submitted and agreed to be accountable for all aspects of the work.
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Raghuram, K., Isaac, M., Yang, J. et al. Neurodevelopmental outcomes in infants treated with intravitreal bevacizumab versus laser. J Perinatol 39, 1300ā1308 (2019). https://doi.org/10.1038/s41372-019-0420-z
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DOI: https://doi.org/10.1038/s41372-019-0420-z
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