376 Section IX ■ Miscellaneous Procedures
neovascular disease (1.25 mg), and may represent a
several-fold increase in drug delivered/body weight
c. No protocol for near- and long-term monitoring of
bevacizumab in neonates has been developed.
drug, and the lack of long-term results, including
the possibility of unknown systemic side effects.
a. Threshold ROP in posterior Zone 1 disease. An
early report showed benefit over laser in posterior
b. In unstable infants in whom laser may be contraindicated
(1) Intravitreal injection does not require systemic
sedation/anesthesia; in this regard, the procedure
may be preferable to laser in unstable infants.
c. As salvage therapy if laser treatment has not been
a. Infection in or around the eyes
c. Failure of consensus between parent(s), treating
physicians, and hospital personnel about the uncertain nature of intravitreal bevacizumab in ROP and
the risks of intravitreal injection (informed consent)
(1) Determines the need for treatment
(2) Participates in informed consent process
(3) Administers topical anesthetic
(5) Performs indirect ophthalmoscopy after the
Table 52.3 Ocular Complications of
Paracentesis (withdrawal of fluid from anterior
Prompt treatment with intravitreal antibiotics
Retinal detachment Incisional surgery (vitrectomy)
(6) Follows the baby for ocular complications and
(1) Provides information about the status of the
infants to the treating ophthalmologist
(2) Participates in the informed consent process
(3) Monitors infant for systemic complications during and after treatment
(1) Helps prepare the baby for injection (i.e., swaddles the baby)
(2) Helps prepare the instruments at the bedside
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