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.研究目的：低出生体重早产儿与早产儿视网膜病变（Retinopathy of Prematurity, ROP）的发病风险显著升高相关。近年来，玻璃体内注射抗血管内皮生长因子（anti-vascular endothelial growth factor, VEGF）已成为ROP治疗的常用方案。尽管抗VEGF疗法已被证实具有确切疗效，但ROP复发的病例仍时有报道。目前针对抗VEGF单药治疗后复发的ROP，仍缺乏标准化治疗方案，针对极低出生体重早产儿的相关方案尤为匮乏。本研究综述了复发型ROP的潜在治疗手段及相关临床挑战。病例报告：本文报告1例出生体重仅500g的极低出生体重早产儿，其在接受初始贝伐珠单抗玻璃体内注射（intravitreal Bevacizumab, IVB）治疗后出现ROP复发，后续经再次注射治疗后成功康复。经36个月的长期随访，未观察到视网膜脱离或ROP复发的情况。结论：本病例报告凸显了ROP临床管理的复杂性，尤其是针对极低出生体重早产儿的复发型ROP治疗。初始IVB治疗后，极低出生体重早产儿若出现ROP复发，再次注射抗VEGF药物或可使其临床获益。