Long-term Refractive Results After Anti-VEGF and Other Treatments in ROP

Overview

This systematic review and meta-analysis evaluated long-term refractive outcomes in ROP survivors treated with anti-VEGF, laser photocoagulation, cryotherapy, and vitrectomy. Anti-VEGF treatment was associated with the least myopic spherical equivalent and lower prevalence of high myopia compared to other treatments.

Background

Retinopathy of prematurity (ROP) is a significant cause of childhood blindness, with survivors often developing myopia. Understanding the refractive outcomes of various treatments is crucial for guiding clinical decisions and managing long-term visual health in these patients. This study synthesizes data from multiple studies to provide insights into the refractive consequences of different ROP therapies.

Data Highlights

Key Findings

• Anti-VEGF treatment resulted in a mean spherical equivalent of -1.9 D, the least myopic outcome among treatments.
• High myopia prevalence was significantly lower after anti-VEGF (21.3%) compared to laser (42.6%) and vitrectomy/cryotherapy (55.4-58.6%).
• Anti-VEGF reduced the risk of high myopia compared to laser therapy (RR = 0.39; 95% CI: 0.25–0.61).
• Moderate to high heterogeneity was observed across studies (I2 = 52%–78%).
• Long-term refractive outcomes should be considered in treatment selection and follow-up planning for ROP patients.

Clinical Implications

The findings suggest that anti-VEGF therapy may be the preferred treatment option for minimizing myopic outcomes in ROP survivors. Clinicians should incorporate these long-term refractive consequences into their treatment planning and follow-up strategies.

Conclusion

This systematic review highlights the favorable refractive outcomes associated with anti-VEGF treatment in ROP, emphasizing the need for careful consideration of treatment options to optimize visual prognosis.

Related Resources & Content

1. Frontiers, Source, 2026 -- Long-term Refractive Results After Anti-VEGF and Other Treatments in ROP
2. Retinal Physician, Source, 2021 -- Anti-VEGF Therapy for Management of Retinopathy of Prematurity
3. Retinal Physician, Source, 2024 -- Anti-VEGF Therapy for Retinopathy of Prematurity
4. International Classification of Retinopathy of Prematurity, Third Edition, Source, 2021
5. Ophthalmology Management — Retina Roundup
6. Retinal Physician — Management of Recurrent Vitreous Hemorrhage After Diabetic Vitrectomy
7. Ophthalmology Management — Retina Roundup
8. International Classification of Retinopathy of Prematurity, Third Edition
9. Refractive Outcomes Following Bevacizumab Monotherapy Compared With Conventional Laser Treatment: A Randomized Clinical Trial | Neonatology | JAMA Ophthalmology | JAMA Network
10. Frontiers | Refractive Outcomes Following Anti-VEGF, Vitrectomy, Cryotherapy, and Laser Photocoagulation for Retinopathy of Prematurity: A Systematic Review and Meta-Analysis