The Short‑Term Effects of Intravitreal Injection of Bevacizumab on the Plasma Levels of Vascular Endothelial Growth Factor, Insulin‑Like Growth Factor‑1, and Growth Parameters in Infants with Retinopathy of Prematurity

To determine the changes in serum levels of free vascular endothelial growth factor (VEGF), insulin‑like growth factor‑1 (IGF‑1), and growth parameters in infants with retinopathy of prematurity (ROP) who received intravitreal injection of the bevacizumab (IVB).

A prospective interventional case series study, including 10 infants with Type 1 ROP was conducted. Using the enzyme‑linked immunosorbent assay, serum levels of VEGF and IGF‑1 were measured before, 1 month and 2 months after treatment with IVB in both eyes. Growth parameters, including weight, length, and head circumference and their Fenton’s z‑score, were also measured.

Serum VEGF levels were suppressed 1 month after IVB (P = 0.007) and then increased between 1 and 2 months (P = 0.064). Z‑scores of all growth parameters except weight z‑score decreased in the 1st and 2nd months.

Serum VEGF levels showed a transient reduction after IVB which lasted at least 2 months. Growth velocity of premature infants may be affected by anti‑VEGF therapy and should be followed with particular attention.