Anti-VEGF versus laser photocoagulation for ROP treatment

Retinopathy of prematurity (ROP) is a vascular disease of the developing retina and a key, but mostly avoidable, cause of blindness in infants (especially preterm and very low birth weight infants). Hence in this prospective comparative cohort study of 1188 screened infants, 77 infants needed treatment; 67 of them received intravitreal anti-VEGF and 10 received laser photocoagulation. Intravitreal anti-VEGF has shown anatomical regression in 96.82 of treated eyes; of which 3.17% required auxiliary laser and primary laser anatomical success was 100% but ablate the peripheral retina more and theoretically presents a greater risk of myopic shift. Aggressive posterior ROP (APROP) which was observed in 5.5 percent of the cohort responded to anti -VEGF in most cases, although isolated but serious complications were identified including cataract and retinal detachment, which demonstrates the importance of careful long-term follow-up. Thus Anti-VEGF was also useful in Type 1 ROP, but the current study also makes progress in demonstrating in a clinical setting that anti-VEGF can yield high regression with low adjunctive laser and superior peripheral retinal sparing, as opposed to laser which has a little higher one-time anatvi-success, indicating that a customized, zone- and stage-based, risk-benefit-driven decision on which therapy to use in any infant is possible.