Concerns for Development After Bevacizumab Treatment of ROP.

Until recently, the treatment of potentially blinding retinopathy of prematurity (ROP) has been relatively straightforward. The 2003 publication1 of the multicenter ETROP (Early Treatment for Retinopathy of Prematurity) randomized trial indicated improved outcomes with the use of peripheral retinal ablation for eyes with type 1 ROP, defined as zone I ROP with plus disease (ie, abnormal dilation and/or tortuosity of the posterior pole vessels), zone I stage 3 ROP without plus disease, or zone II stage 2 or 3 ROP with plus disease. Among 401 infants with birth weights <1251 g at 26 US clinical centers, 342 of 370 survivors were examined at age 6 years.2 One in 4 had visual acuity worse than 20/200 in the laser-treated eye with type 1 ROP. This finding represents a marked improvement in visual function compared with the natural history of severe ROP found in untreated eyes in the CRYO-ROP (Cryotherapy for Retinopathy of Prematurity) study conducted 15 years earlier.3 In the earlier study, 52% of control (untreated) eyes with slightly worse than type 1 ROP had 20/200 or worse visual acuity.4