Scholarlink

Background <p>Retinopathy of prematurity (ROP) is a leading cause of childhood blindness. Anti-vascular endothelial growth factor (anti-VEGF) therapy offers an alternative to laser photocoagulation, recurrence, and retreatment, particularly in Zone II disease.</p> Methods <p>We conducted a systematic review and meta-analysis of studies published from 2010 to 2025 comparing anti-VEGF agents (bevacizumab, ranibizumab, aflibercept) with laser therapy in preterm infants with treatment-requiring ROP. Primary outcomes were recurrence and retreatment; secondary outcomes included time to recurrence, structural, and refractive outcomes. The risk of bias was assessed using RoB 2 and ROBINS-I tools, and the certainty of evidence was evaluated using GRADE.</p> Results <p>Fifteen studies with 1,784 eyes were included. Pooled recurrence (RR 1.78, 95% CI: 0.56–5.65) and retreatment rates (RR 1.80, 95% CI: 0.54–5.94) showed no statistically significant differences, with substantial heterogeneity (I²&gt;80%). Subgroup analysis showed lower recurrence in Zone I (RR 0.52) but higher recurrence in Zone II (RR 3.42) following anti-VEGF therapy. Ranibizumab was associated with higher recurrence compared to other agents. After anti-VEGF therapy, recurrence occurred variably between 7 and 50 + weeks of post-treatment. GRADE assessment indicated low certainty for recurrence and retreatment, moderate for structural and refractive outcomes, and very low for neurodevelopmental safety.</p> Conclusion <p>Anti-VEGF therapy is effective for Zone I ROP, but Zone II treatment requires careful monitoring due to higher recurrence and retreatment risk. Standardized protocols and extended follow-up are essential, and further high-quality studies are needed to optimize ROP management.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Anti-VEGF versus laser therapy for retinopathy of prematurity: a systematic review and meta-analysis focusing on recurrence patterns and retreatment needs

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年1月30日

查看全文
  • Luksanaporn Krungkraipetch,
  • Dechathorn Krungkraipetch,
  • Kitti Krungkraipetch

摘要

Background

Retinopathy of prematurity (ROP) is a leading cause of childhood blindness. Anti-vascular endothelial growth factor (anti-VEGF) therapy offers an alternative to laser photocoagulation, recurrence, and retreatment, particularly in Zone II disease.

Methods

We conducted a systematic review and meta-analysis of studies published from 2010 to 2025 comparing anti-VEGF agents (bevacizumab, ranibizumab, aflibercept) with laser therapy in preterm infants with treatment-requiring ROP. Primary outcomes were recurrence and retreatment; secondary outcomes included time to recurrence, structural, and refractive outcomes. The risk of bias was assessed using RoB 2 and ROBINS-I tools, and the certainty of evidence was evaluated using GRADE.

Results

Fifteen studies with 1,784 eyes were included. Pooled recurrence (RR 1.78, 95% CI: 0.56–5.65) and retreatment rates (RR 1.80, 95% CI: 0.54–5.94) showed no statistically significant differences, with substantial heterogeneity (I²>80%). Subgroup analysis showed lower recurrence in Zone I (RR 0.52) but higher recurrence in Zone II (RR 3.42) following anti-VEGF therapy. Ranibizumab was associated with higher recurrence compared to other agents. After anti-VEGF therapy, recurrence occurred variably between 7 and 50 + weeks of post-treatment. GRADE assessment indicated low certainty for recurrence and retreatment, moderate for structural and refractive outcomes, and very low for neurodevelopmental safety.

Conclusion

Anti-VEGF therapy is effective for Zone I ROP, but Zone II treatment requires careful monitoring due to higher recurrence and retreatment risk. Standardized protocols and extended follow-up are essential, and further high-quality studies are needed to optimize ROP management.