Neurodevelopmental Outcomes of Two Intravitreal Bevacizumab Dosages in Preterm ROP Infants

Abstract Purpose To compare neurodevelopmental outcomes, assessed by Bayley Scales of Infant Development (BSID) and Bayley Infant Neurodevelopmental Screener (BINS) scores, between low-dose and high-dose intravitreal bevacizumab (IVB) in preterm infants treated for retinopathy of prematurity (ROP). Methods A retrospective chart review identified infants who received IVB for ROP and completed a BSID (edition 3 or 4) and/or BINS test at a quaternary care pediatric hospital (2011–2024). Patients were divided into high-dose (0.05 mL) and low-dose (0.025 or 0.03 mL) IVB cohorts. BSID/BINS scores and cohort characteristics (gestational age and weight, birth weight, age at injection, age at testing) were compared using t-tests and Fisher exact tests (significance, p < 0.05). Results Of 89 patients who received IVB, 23 completed a BSID test (10 low-dose, 13 high-dose) and met criteria for analysis. Forty completed at least one BINS subtest. No significant differences were found between dose cohorts for cohort characteristics, all BSID subscores (after p-values were Bonferroni-corrected), any BINS subscore across four age-stratified subtests (3–4, 5–6, 7–10, and 11–15 months), risk-interpretation distributions, or comorbidity distributions. Conclusions In unadjusted comparisons of developmental and cohort characteristics, this study found no evidence that lower IVB dosage improves early neurodevelopmental outcomes in preterm infants with ROP. Larger, prospective studies are needed to clarify IVB's neurodevelopmental safety profile.