Supplementary Material for: Repeat Intravitreal Bevacizumab in a Very Low Birth Weight Infant with Recurrent ROP: 3-Year Follow-Up and Literature Review

Purpose: Low gestational birth weight is associated with increased incidence of Retinopathy of Prematurity (ROP). In recent years, intravitreal injection of anti-vascular endothelial growth factor (VEGF) has become more prevalent for ROP. Despite the demonstrated effectiveness following anti-VEGF injection, recurrence of ROP has been reported. A standardized treatment protocol for recurrent ROP following anti-VEGF monotherapy is still lacking, particularly for extremely low birthweight infants. This study reviews possible treatments for recurrent ROP and associated challenges. Case Report: We report a very low birth weight infant (500g) with a recurrence of ROP after the initial intravitreal Bevacizumab (IVB) injection, who was successfully treated with a repeat injection at a later date. No retinal detachment or no recurrence was observed after a long term follow up of 36 months. Conclusion: This case report highlights the complexity of managing ROP, particularly for recurrent ROP in very low birth weight infants. Premature infants with extremely low birth weight may benefit from a repeat injection of anti-VEGF after the initial IVB to treat the recurrence.