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Reply to letter to editor: Neurodevelopmental outcomes following bevacizumab treatment for retinopathy of prematurity: a systematic review and meta-analysis

Journal of Perinatology volume 41, pages 2692–2693 (2021)Cite this article

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We thank the authors for their interest in our systematic review, which evaluated neurodevelopmental outcomes of preterm infants with severe retinopathy of prematurity (ROP) treated with bevacizumab compared to laser ablation or cryotherapy [1]. The authors highlight the following concerns: selection bias in observational studies that showed an association between bevacizumab and neurodevelopment impairment, lack of association between bevacizumab and neurodevelopment impairment in a clinical trial and other less biased observational studies, and lack of inclusion of Fan et al. study [2].

The authors state that three studies in the systematic review showing an association between bevacizumab and neurodevelopmental impairment suffered from selection bias [3,4,5]. They also mention that they dominated the conclusion as they contributed to more than half of patients. In contrast, the remainder of the observational studies and the clinical trial [6], which were at less risk of bias, showed no association between bevacizumab and neurodevelopmental impairment.

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References

  1. Kaushal M, Razak A, Patel W, Pullattayil AK, Kaushal A. Neurodevelopmental outcomes following bevacizumab treatment for retinopathy of prematurity: a systematic review and meta-analysis. J Perinatol. 2020. https://doi.org/10.1038/s41372-020-00884-9.

  2. Fan YY, Huang YS, Huang CY, Hsu JF, Shih CP, Hwang YS, et al. Neurodevelopmental outcomes after intravitreal bevacizumab therapy for retinopathy of prematurity: a prospective case-control study. Ophthalmology. 2019;126:1567–77.

  3. Arima M, Akiyama M, Fujiwara K, Mori Y, Inoue H, Seki E, et al. Neurodevelopmental outcomes following intravitreal bevacizumab injection in Japanese preterm infants with type 1 retinopathy of prematurity. PLoS ONE. 2020;15:e0230678.

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  4. Rodriguez SH, Peyton C, Lewis K, Andrews B, Greenwald MJ, Schreiber MD, et al. Neurodevelopmental outcomes comparing bevacizumab to laser for type 1 ROP. Ophthalmic Surg Lasers Imaging Retina. 2019;50:337–43.

  5. Anand N, Blair MP, Greenwald MJ, Rodriguez SH. Refractive outcomes comparing primary laser to primary bevacizumab with delayed laser for type 1 ROP. J AAPOS. 2019;23:88E1–6.

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  6. Kennedy KA, Mintz-Hittner HA. Medical and developmental outcomes of bevacizumab versus laser for retinopathy of prematurity. J AAPOS. 2018;22:61–65.e1.

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Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, King Abdullah bin Abdulaziz University Hospital, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia

    Abdul Razak

  2. Division of Neonatology, Department of Pediatrics, Emirates Specialty Hospital, Dubai, United Arab Emirates

    Monika Kaushal

Authors
  1. Abdul Razak
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  2. Monika Kaushal
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Correspondence to Abdul Razak.

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Razak, A., Kaushal, M. Reply to letter to editor: Neurodevelopmental outcomes following bevacizumab treatment for retinopathy of prematurity: a systematic review and meta-analysis. J Perinatol 41, 2692–2693 (2021). https://doi.org/10.1038/s41372-021-01127-1

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