Editorial
Bevacizumab (Avastin) for retinopathy of prematurity: Wrong dose, wrong drug, or both?

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      These studies should be interpreted with caution, because treatment methods generally were not randomized and sicker infants tended to be treated with anti-VEGF agents instead of laser therapy.45 Finally, ideal dosing of bevacizumab for ROP has yet to be established.46–48 Wallace et al49 recently demonstrated good results with 0.004 mg, considerably less than the 0.625 mg used in the Bevacizumab Eliminates the Angiogenic Threat of ROP Study.

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      One dose of bevacizumab, an anti-VEGF agent, led to persistent avascular retina and recurrent disease,85,160 even 2.5 years later.2,10,64,67,83,149,160–163,166–168 The direct comparison of anti-VEGF treatment between premature infant and adult eyes also suggests that ¼ the dose in vitreous in the infant eye would still be much less diluted in the many fold smaller infant blood volume compared to the adult.17,66 VEGF is important to kidney, brain, and lung development, as well as to retinal health.60

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