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

Introduction: 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 birth weight infants. This study reviews possible treatments for recurrent ROP and associated challenges. Case Presentation: We report a very low birth weight infant (500 g) 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 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.