5 ROP retinal detachment after bevacizumab monotherapy.
Indeed, we have detected a new retinal detachment as late as
72 weeks PMA. We speculate that the anti-VEGF treatment
was inadequately effective in these cases because the dos-
age did not match the load or duration of the endogenous
VEGF production. As a result, in some cases despite a
dramatic early response, the blocking effect wanes and
recurrence may occur. We have observed that this reactiva-
tion of proliferative ROP after bevacizumab may occur at
the original posterior site of extraretinal fibrovascular pro-
liferation rather than at the junction of the vascular and
avascular retina. Undetected, this recurrence of ROP may
lead to rapid retinal detachment and blindness. Recognizing
that the disease pattern after laser treatment, which has
shaped current clinical practice, is less predictive when
applied to eyes treated with bevacizumab should addition-
ally increase vigilance.
Indeed, we have detected a new retinal detachment as late as
72 weeks PMA. We speculate that the anti-VEGF treatment
was inadequately effective in these cases because the dos-
age did not match the load or duration of the endogenous
VEGF production. As a result, in some cases despite a
dramatic early response, the blocking effect wanes and
recurrence may occur. We have observed that this reactiva-
tion of proliferative ROP after bevacizumab may occur at
the original posterior site of extraretinal fibrovascular pro-
liferation rather than at the junction of the vascular and
avascular retina. Undetected, this recurrence of ROP may
lead to rapid retinal detachment and blindness. Recognizing
that the disease pattern after laser treatment, which has
shaped current clinical practice, is less predictive when
applied to eyes treated with bevacizumab should addition-
ally increase vigilance.
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