Retinopathy of Prematurity (ROP)—Risk Factors and Therapeutic Effect of Intravitreal Injection of Bevacizumab (IVB): An Observational Study from a Neonatal Intensive Care Unit in Egypt

Abstract

Abstract Objectives: To study the epidemiological and demographic data of retinopathy of prematurity (ROP) as well as the effectiveness of intravitreal injection of bevacizumab (IVB) as monotherapy for type I ROP in a local neonatal intensive care unit in Egypt. Methods: An observational study, where the medical records of all babies eligible for ROP screening over a period of 12 months (2020–2021) were reviewed. The screening results were reported in stage, zone, extent, and plus disease. Babies with type 1 ROP were eligible for treatment with IVB. Their medical files were reviewed for possible risk factors associated with ROP. The primary outcomes were the presence or absence of ROP, eligibility for IVB, complications of IVB and regression or recurrence of ROP. Results: ROP affects a significant proportion of babies (55%). The lower the birth weight (and accordingly, the gestational age [GA]), the higher the incidence of ROP. Recurrent apnea, mechanical ventilation, and continuous positive airway pressure were associated with a significant risk for ROP. On the other hand, nasal cannula, sepsis, and blood transfusion did not significantly increase the risk of ROP. Although common, most cases (48.6%) had type 2 ROP and only required follow-up. IVB was effective and safe in arresting disease progression in 93% of the remaining patients with type 1 ROP (6.4%). Conclusion: ROP is a significant cause of morbidity in preterm babies in Egypt. Low birth weight, apnea, and respiratory support are significant risk factors. Most cases are mild and only require follow-up. Up to 6.4% of the cases had type 1 ROP. Monotherapy with IVB appears to be effective and safe. Neonatal care has to be optimized to further reduce the current incidence rate of ROP.