Retinopathy of prematurity outcomes better with anti-VEGF than primary laser treatment

Children with retinopathy of prematurity (ROP) who receive antivascular endothelial growth factor (anti-VEGF) therapy fare better than their counterparts who undergo primary laser treatment, a study has found.

The retrospective analysis included 175 infants (350 eyes, mean gestational age 28.2 weeks, birth weight 1,059 grams) out of a screening population of 539 infants (1,078 eyes, 32.4 percent follow-up) over a 9-year period. The included infants were followed with outpatient eye exams, where researchers recorded birth characteristics, worst type of ROP, and ROP treatment. Snellen visual acuity was assessed for children aged ≥4 years.

In total, 15 eyes received primary anti-VEGF therapy while 59 eyes had primary laser therapy. Compared with laser, anti-VEGF therapy resulted in a much lower incidence of amblyopia (adjusted odds ratio [aOR], 0.6–0.86; p<0.0001) after controlling for gestational age and birth weight.

Meanwhile, there were no significant between-group differences in the rates of optic atrophy (p=0.79), strabismus (p=0.98), and myopia (p=0.93). However, infants who received anti-VEGF therapy had more posterior disease than laser-treated infants (p=0.041).

When compared with untreated infants, those who received laser therapy did not seem to have better outcomes, such that they were more likely to have severe myopia (aOR, 1.02–1.3; p=0.023), amblyopia (aOR, 1.12–1.61; p=0.002), and optic atrophy (aOR, 1.01–1.32; p=0.045).

The findings contribute to data regarding the advantages of anti-VEGF treatment relative to primary laser treatment.