Journal of Pediatric Ophthalmology & Strabismus e41 Short Subjects ABSTRACT The authors report refractive errors possibly resulting from intravitreal bevacizumab injection. Triplet A pre- sented with stage 3 retinopathy of prematurity, was treated with intravitreal bevacizumab, and high refrac- tive errors were noted. Triplet B presented with stage 2 retinopathy of prematurity in the right eye and stage 3 retinopathy of prematurity in the left eye, which re- gressed spontaneously. Triplet C presented with stage 2 retinopathy of prematurity in the right eye and stage 3 retinopathy of prematurity in the left eye, which were treated with intravitreal bevacizumab. [J Pediatr Oph- thalmol Strabismus 2012;49:e41-e43.] INTRODUCTION Retinopathy of prematurity (ROP) is a neovas- cular retinal disorder with highly elevated vascular endothelial growth factor (VEGF) levels in vitre- ous fluid. 1 It occurs primarily in infants born pre- maturely before 31 weeks’ gestational age with low birth weight (1,250 g or less). 2 Peripheral retinal ablation with conventional la- ser therapy or cryotherapy is a proven treatment to destroy the majority of the cells that produce VEGF in the retina, but some destructive complications cannot be averted. 3,4 The current study shows supe- rior efficacy of intravitreal bevacizumab (IVB) injec- tion over peripheral retinal ablation as measured by means of disease recurrence and abnormal structural outcomes. 2 Although IVB injection has shown satis- factory results in treating ROP, the long-term safety remains uncertain. In the literature, there is no report focusing on the refractive status after IVB injection in ROP. We highlight a case of high refractive errors possibly re- sulting from IVB injection in triplets with ROP. CASE REPORTS Triplet A was a boy of 28 weeks’ gestational age weighing 1,039 g at birth. He presented with zone 2, stage 3 plus ROP in both eyes at 38 weeks’ post- menstrual age and was treated with IVB injection of 0.625 mg (0.025 mL) via the pars plicata at 2 mm behind the limbus. Disappearance in retinal vessel tortuosity and neovascularization was noted after the treatment, and vascularization toward the pe- ripheral retina with absence of recurrence was noted by 53 weeks’ postmenstrual age and until 1 year of follow-up. However, high myopia with axial length elongation in both eyes (23.97 and 22.85 mm) was noted at the age of 1 year and 4 months. Triplet B was a girl weighing 1,082 g at birth who presented with zone 2, stage 2 ROP in the right eye and stage 3 ROP in the left eye at 45 weeks’ postmen- strual age. Full regression of ROP was noted under observation and the peripheral retina was well vascu- larized at the 1-year follow-up. Both eyes had mild Different Refractive Errors in Triplets With Retinopathy of Prematurity Treated With Bevacizumab Chien-Chi Tseng, MD; San-Ni Chen, MD; Jiunn-Feng Hwang, MD; Chun-Ju Lin, MD From the Department of Ophthalmology (C-CT, S-NC, J-FH, C-JL), Changhua Christian Hospital, Changhua; the School of Medicine (S-NC, J-FH, C-JL), Chung Shan Medical University, Taichung; and the Department of Optometry (C-JL), Chung Hwa University of Medical Technology, Tainan, Taiwan. Originally submitted May 15, 2011. Accepted for publication May 30, 2012. Posted online August 7, 2012. The authors have no financial or proprietary interest in the materials presented herein. Address correspondence to Chun-Ju Lin, MD, Department of Ophthalmology, 135 Nanxiao St., Changhua, Taiwan. E-mail address: doctoraga@gmail.com doi: 10.3928/01913913-20120731-03