Keeping an Eye on Infant Eye Disease

Bevacizumab injection for retinopathy of prematurity linked to low blood pressure in infants

/ Author:  / Reviewed by: Jennifer Gershman, PharmD, CPh

(RxWiki News) For babies at risk of blindness, one common treatment may do more harm than good.

A new report from Taiwan found that the anti-cancer drug bevacizumab (brand name Avastin) may cause abnormally low blood pressure when used off-label to treat retinopathy of prematurity (ROP), an eye disease that commonly affects babies born prematurely.

ROP causes abnormal blood vessels to grow in the retina, a light-sensitive layer of tissue at the back of the eye. This growth can cause the retina to detach from the eye and lead to blindness. Some cases of ROP are mild and correct themselves, but others require surgery to prevent vision loss or blindness.

Avastin is currently approved by the US Food and Drug Administration (FDA) to treat colon, kidney, lung and several other forms of cancer. The drug works by blocking the growth of blood vessels that tumors use to sustain themselves.

It is also widely used to treat adult eye diseases like diabetic retinopathy — a phenomenon which the authors of this report found concerning.

"Off-label use of [Avastin] for ROP is increasing, despite the lack of studies on its safety," wrote lead author Ching-Lan Cheng, PhD, of National Cheng Kung University in Taiwan, and colleagues. "The potential for systemic adverse events exists and should not be ignored. Thus, the safety of [Avastin] in preterm infants with ROP should be established with further studies."

For this report, Dr. Cheng and team looked at a pair of preterm twins with ROP treated with Avastin. Before treatment, both twins had similar and stable health.

Twin B, a boy, developed abnormally low blood pressure within one day after treatment. Because low blood pressure in babies can prevent the organs from getting enough blood and oxygen to work well, he was then put on antibiotics and blood pressure medications for the next two days. On the third day, his blood pressure returned to normal and his health stabilized shortly after.

Twin A, a girl, did not develop low blood pressure after treatment.

This was a very small study. More research is needed to confirm these findings.

This study was published online Jan. 7 in the journal Pediatrics. No funding sources or conflicts of interest were disclosed.

Review Date: 
January 6, 2016
Last Updated:
January 7, 2016