<P>The anatomic response to intravitreal bevacizumab injection in three patients with aggressive, posterior retinopathy of prematurity is described. In all cases, the worse eye was treated with a single intravitreal injection of 0.75 mg of bevacizumab as monotherapy or complementary to laser therapy. In 24 hours, all injected eyes showed regression of the tunica vasculosa lentis and iris vessel engorgement and disappearance of iris rigidity. In addition, plus disease and retinal proliferation began to regress. None of the eyes required additional treatment. Follow-up of up to 10 months showed good anatomic outcomes and no evidence of local or systemic adverse events. [<CITE>Ophthalmic Surg Lasers Imaging</CITE> 2007;38:233-237.]</P> <H4>AUTHORS</H4> <P>From the Pediatric Retina Department (ST, FEE, IP, GP), Ophthalmology Service, Hospital Fernando Fonseca, Lisbon; the Surgical Center of Coimbra (AT, IR, AST, RV), Coimbra; the Ophthalmology Department (PF), Centro Hospitalar de Lisboa, Zona Central, Hospital de S. José, Lisbon; Alfredo da Costa Maternity (AV), Lisbon; and the High Commissary for Portuguese Health (MCM), Lisbon, Portugal.</P> <P>Accepted for publication February 26, 2007.</P> <P>Presented at the World ROP Meeting, Vilnius, Lithuania, September 14-16, 2006. Abstract number 015.</P> <P>The authors thank Drs. Stephan Michels and Rike Michels for their support.</P> <p>Address correspondence to Susana Teixeira, MD, Pediatric Retina Department at the Service of Ophthalmology, Hospital Fernando Fonseca, R. João de Freitas Branco nº 21, 6º D, 1500-714 Lisboa, Portugal. E-mail: <a href="mailto:susanateixeira.oft@gmail.com">susanateixeira.oft@gmail.com</a>.</p>

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Introduction: Certain injuries, especially those with a deep-impact (involving the choroid and even the sclera) intraocular foreign body (IOFB), have a high risk for developing either full-blown proliferative vitreoretinopathy (PVR) or full-thickness retinal folds. Although less severe than the former, this so-called ‘stage 0 PVR’ can severely impact vision, and effective treatment for these folds has not existed heretofore. Patients and Methods: Four eyes of 4 patients sustained an IOFB injury with deep impact. All eyes underwent vitrectomy and IOFB removal soon after the injury, and all eyes showed substantial visual improvement postoperatively. However, in a few months the visual acuity dropped again, due to the development of full-thickness retinal folds radiating from the scar. All four eyes then underwent a second vitrectomy with (late rather than prophylactic) chorioretinectomy by creating a 1-mm-wide ring of bare sclera around the scar. The highest setting of the diathermy machine was used as the endodiathermy probe evaporated both the retina and the choroid to create the ring. Laser retinopexy to surround the ring was used only if the lesion was not in the posterior pole. Results: Within a few days, the retinal folds completely disappeared in each eye, and the visual acuity reached the highest earlier value seen after the initial surgery. All patients have long-term follow-up (mean, 22 months) with no postoperative complications. Conclusions: Chorioretinectomy, although it is ideally used as a prophylaxis against PVR formation and the development of retinal fold formation, also proved equally effective as a late treatment option in the presence of such folds. Such late chorioretinectomy, however, is applicable only for eyes with deep-impact IOFB injuries, not for eyes with a perforating injury or rupture.

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