Bevacizumab for Retinopathy of Prematurity is Not Associated With Systemic Hypertension.

Purpose: To evaluate for an association between systemic hypertension and intravitreal bevacizumab (IVB) for retinopathy of prematurity (ROP) treatment, due to a 2020 case report of a neonate with ROP developing systemic hypertension and posterior reversible encephalopathy syndrome (PRES) after IVB and limited data on long-term safety of IVB.

Methods: A retrospective cohort study was conducted using vital signs for 90 days, comparing IVB to laser treatment. The primary outcome was short-term hypertension, recorded for at least 3 consecutive days following treatment. As a secondary outcome, infants treated with IVB were also compared to infants with severe ROP who experienced spontaneous regression without treatment. Rates of long-term hypertension, based on chart diagnoses at discharge, were also reviewed. Neuroimaging was re-reviewed to evaluate for vasogenic edema consistent with PRES.

Results: Overall, 137 infants with severe ROP were included, of whom 94 required treatment. There were no baseline differences in neonatal comorbidities comparing laser to IVB. There was no difference on unadjusted or adjusted logistic regression comparing odds of short-term hypertension after IVB to laser (adjusted odds ratio: 0.69, 095% CI: 0.25, 1.87). There was no significant difference in the rate of long-term hypertension diagnoses by treatment group.

Conclusions: The lack of association between IVB and short-term systemic hypertension is reassuring. Further studies are warranted to confirm this. [J Pediatr Ophthalmol Strabismus. 202X;XX(X):XXX-XXX.].