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Purpose: To examine the characteristics of the foveal vascular structure of patients with retinopathy of prematurity (ROP) by optical coherence tomography angiography., Methods: Ten patients with a history of laser photocoagulation or cryopexy treatment for Stage 3 (Zone ≥ II) ROP and 10 normal subjects (controls) were included. Foveal avascular zone, vessel density, vessel length, and vascular diameter index were measured by optical coherence tomography angiography using the 3 × 3-mm Early Treatment Diabetic Retinopathy Study (ETDRS) sectors., Results: The median foveal avascular zone values of the patients with ROP and controls were 0.103 mm and 0.260 mm, respectively (P = 0.0025). The medians of the vessel density, vessel length, and vascular diameter index of the patients with ROP were 0.218 mm/mm, 11.75 mm/mm, and 18.00 μm, respectively, in ETDRS Sector 1 and did not significantly differ from those of the controls (P = 0.940, 0.733, and 0.705, respectively). For the average of ETDRS Sectors 2 to 5, the medians of the vessel density, vessel length, and vascular diameter index for the patients with ROP were 0.347 mm/mm, 18.95 mm/mm, and 18.28 μm, respectively; vessel density and vessel length were significantly smaller than those of the controls (P = 0.002 and 0.003, respectively), but there was no significant difference in vascular diameter index (P = 0.286)., Conclusion: Optical coherence tomography angiography-guided foveal avascular zone was significantly smaller in patients with ROP than in controls. Our results indicate that foveal vascular development may be altered in patients with a history of treatment-requiring ROP.

Purpose: To determine whether an intravitreal injection of bevacizumab alters the concentration of vascular endothelial growth factor (VEGF) in the aqueous humor of eyes with retinopathy of prematurity., Methods: Seven Stage 4 and three Stage 5 eyes of eight patients with retinopathy of prematurity were studied. Bevacizumab (0.75 mg/0.03 mL/eye) was injected intravitreally in six eyes of six patients after approval was obtained from the Institutional Review Board of Nagoya University Hospital and an informed consent was signed by the parents. Aqueous humor was collected just before the surgery or before the intravitreal injection of bevacizumab. Aqueous humor was also collected immediately before vitrectomy 4 to 48 days after the injection of bevacizumab. Aqueous humor was also collected from four patients undergoing congenital cataract surgery as controls. The concentration of VEGF was measured by enzyme-linked immunosorbent assay., Results: In the 4 control eyes, the concentration of VEGF in 2 eyes was 156 and 158 pg/mL and was not detectable in the other 2 eyes. The average concentration of VEGF was 1,109 pg/mL in the active Stage 4 eyes and 3,520 pg/mL in the active Stage 5 eyes. After bevacizumab injection, the unbound VEGF concentration was 60, 230, and 290 pg/mL in 3 eyes and not detectable in 1 eye., Conclusion: Intravitreal bevacizumab resulted in a marked decrease in the unbound VEGF concentration in eyes with retinopathy of prematurity.