Avastin Injections for Retinopathy of Prematurity (ROP)
Courtney was 24 weeks pregnant and en route from Costa Rica to her home in New York City when her water broke on the plane. At a scheduled stop in Houston, paramedics helped her deplane. She was transported from George Bush Intercontinental Airport to nearby Memorial Hermann Northeast Hospital.
“The staff at the hospital was amazing,” Courtney says. “A nurse named Sandy Tucker was phenomenal in expediting my transfer to the Texas Medical Center. It’s so terrifying when something happens away from home and you have no idea what’s going on. Even though our stay at Memorial Hermann Northeast was brief, it was very positive.”
Courtney was admitted to the Women’s Center at Children’s Memorial Hermann Hospital on February 24, 2010, and her daughter Olivia was born one week later, preterm at 25 weeks.
After the delivery, Olivia was admitted to the Neonatal Intensive Care Unit (NICU).
After 48 hours in the ICU, Courtney was moved back to Labor and Delivery and discharged from the hospital a week and a half later on March 18. But Olivia remained hospitalized until June 2 – a total stay of 91 days.
“She was progressing well in the NICU. She was on a ventilator and feeding tube initially, but when she could swallow, feed and maintain proper oxygen saturation on her own, she was transferred to a step-down unit,” Courtney says.
“The unit was beautifully designed and very progressive. Sharing a private room with your hospitalized child and being able to stay with her around the clock is invaluable.”
Olivia developed retinopathy of prematurity (ROP), a common complication and leading cause of retinal detachment and blindness in premature infants.
By the time she was discharged from the NICU, the disease had progressed to Stage 3, which met one of the qualifications for participation in a Phase II trial then under way by researchers at Children’s Memorial Hermann Hospital, investigating the efficacy of intravitreal Avastin™ injections to improve outcomes in infants with ROP.
Led by principal investigator Helen Mintz-Hittner, M.D., a pediatric ophthalmologist affiliated with the hospital and the Alfred W. Lasher III, Professor of Ophthalmology at The University of Texas Health Science Center at Houston (UTHealth) Medical School, the trial, now completed, compared intravitreal bevacizumab (Avastin) injections to conventional laser surgery to improve structural and functional outcomes of vision-threatening ROP.
The UTHealth Medical School was the lead center in the national study, which began in March 2008 and enrolled 150 patients at centers in Texas, California, Colorado, Illinois and South Carolina through October 2010. It was the first randomized, controlled study to compare two very different forms of treatment for ROP in premature babies.
“To be eligible for the trial, infants had to live in reasonable proximity to Houston so that we could follow them for at least five years after treatment and discharge,” Dr. Mintz-Hittner says. “At that time we couldn’t give the drug to hospitalized infants outside the study protocol – although we can treat them now that the study has been completed. So Olivia was discharged from the NICU to my office.”
After examining Olivia several times, Dr. Mintz-Hittner delivered Avastin in one injection to each eye under sterile conditions.
“The therapy eliminates many complications of ROP, including nearsightedness, loss of a portion of the visual field, retinal detachment, strabismus, cataracts and glaucoma,” she says. “Once the eyes are damaged by ROP, it’s irreversible. Intravitreal Avastin is a very simple treatment that changes a child’s life dramatically. The injections are delivered at the bedside, they shorten the hospital stay and they are very inexpensive.”
After their return to New York City, Olivia was followed by a pediatric ophthalmologist at Columbia University Medical Center and later, at Weill Cornell Medical College. She has had no problems.
“We were very, very lucky or blessed or fortunate – however you want to say it,” Courtney says. “That good fortune is hugely attributable to Children’s Memorial Hermann Hospital, and I say that with my most sincere sentiments. It was a life-changing experience. I can’t say enough about how phenomenal the facility and caregivers were.
Coming from the Northeast, we have access to some of the best hospitals in the country, but we were so impressed with the care that we chose to keep Olivia at Children’s Memorial Hermann Hospital.”
1Mintz-Hittner HA, Kennedy KA, Chuang AZ. Efficacy of Intravitreal Bevacizumab for Stage 3+ Retinopathy of Prematurity. New England Journal of Medicine, 364:7(603-615), 17 Feb 2011.