Refractive outcomes following anti-VEGF, vitrectomy, cryotherapy, and laser photocoagulation for retinopathy of prematurity: a systematic review and meta-analysis - Scorecard - MDSpire
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Refractive outcomes following anti-VEGF, vitrectomy, cryotherapy, and laser photocoagulation for retinopathy of prematurity: a systematic review and meta-analysis
Clinical Scorecard: Long-term Refractive Results After Anti-VEGF, Vitrectomy, Cryotherapy, and Laser Photocoagulation in Premature Infants with Retinopathy: A Systematic Review and Meta-Analysis
At a Glance
Category
Detail
Condition
Retinopathy of Prematurity (ROP)
Key Mechanisms
Dysregulated retinal vascular development due to early birth leading to retinal ischemia and neovascularization.
Target Population
Preterm infants diagnosed with ROP.
Care Setting
Neonatal care and pediatric ophthalmology.
Key Highlights
Anti-VEGF treatment associated with least myopic pooled mean spherical equivalent (−1.9 D).
High myopia prevalence: 21.3% after anti-VEGF vs. 42.6% after laser, and 55.4% to 58.6% after vitrectomy or cryotherapy.
Anti-VEGF significantly reduces the risk of high myopia compared to laser (RR = 0.39).
Moderate to high heterogeneity observed in study results (I2 = 52%–78%).
Long-term refractive outcomes should inform treatment selection and follow-up planning.
Guideline-Based Recommendations
Diagnosis
Monitor preterm infants for signs of ROP and assess refractive outcomes post-treatment.
Management
Consider anti-VEGF as a primary treatment option to minimize myopic burden.
Monitoring & Follow-up
Regular follow-up for refractive errors in ROP survivors, especially those treated with cryotherapy and vitrectomy.
Risks
Be aware of potential systemic VEGF suppression and late recurrences with anti-VEGF therapy.
Patient & Prescribing Data
Preterm infants diagnosed with ROP requiring treatment.
Anti-VEGF injections may preserve peripheral retinal vasculature and reduce refractive burden compared to traditional methods.
Clinical Best Practices
Incorporate long-term refractive consequences into treatment planning.
Utilize standardized outcome measures for evaluating refractive outcomes.
Engage in multidisciplinary follow-up care for ROP survivors.
FOXC1 duplications were the second most common monogenic finding among genetically solved juvenile open-angle glaucoma cases in one registry, supporting the use of copy-number variant analysis in early-onset glaucoma testing.
