Comparison of Intravitreal Bevacizumab and Ranibizumab Injections in Aggressive and Type 1 Retinopathy of Prematurity

Purpose: To investigate the differences in treatment effects between primary intravitreal bevacizumab injections and ranibizumab injections in type 1 retinopathy of prematurity (ROP) and aggressive ROP.Methods: We retrospectively analyzed the medical records of 61 eyes from 32 premature infants who underwent primary intravitreal anti-vascular endothelial growth factor (VEGF) injections for ROP. Patients with type 1 or aggressive ROP were divided into two groups: the intravitreal bevacizumab injection group and the ranibizumab injection group. We analyzed the period until plus disease disappeared after the first injection, reactivation, additional treatment, and the primary treatment success rate (cases in which retinal vessels formed to the periphery without additional treatment after the first injection).Results: In the type 1 ROP group, the primary treatment success rates for 16 patients (30 eyes) in the bevacizumab injection group and 6 patients (12 eyes) in the ranibizumab injection group were 100.0% and 91.7%, respectively. In the aggressive ROP group, the primary treatment success rates for 5 patients (9 eyes) in the bevacizumab injection group and 5 patients (10 eyes) in the ranibizumab injection group were 55.6% and 60.0%, respectively. In both type 1 and aggressive ROP, there were no significant differences in the period until plus disease disappeared after the first injection, reactivation rate, or additional treatment rate depending on the type of anti-VEGF.Conclusions: Bevacizumab and ranibizumab demonstrated similar efficacy in type 1 ROP and aggressive ROP. However, because aggressive ROP required additional treatment more frequently regardless of the type of anti-VEGF used, close follow-up after the primary injection is essential.