Comparative efficacy and safety of intravitreal anti-VEGF therapy versus laser photocoagulation in treatment-requiring retinopathy of prematurity Artykuł przeglądowy
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Opublikowane:
sie 3, 2026
Słowa kluczowe:
anti-VEGF, laser photocoagulation, retinopathy of prematurity
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Abstrakt
Retinopathy of prematurity (ROP) remains a leading cause of preventable childhood blindness worldwide. While laser photocoagulation has long been the standard treatment, intravitreal anti-VEGF therapy is increasingly used, particularly for posterior disease. This narrative review integrates data from randomized trials, systematic reviews, and contemporary cohort studies to compare treatment efficacy, recurrence behavior, refractive outcomes, and systemic safety. Anti-VEGF therapy yields comparable regression rates, a lower risk of structural complications, and more favorable refractive outcomes. However, it is associated with a higher risk of reactivation and longer follow-up requirements. Anti-VEGF therapy is now widely favored for zone I and aggressive ROP, while laser remains essential when follow-up reliability is uncertain.
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Jak cytować
1.
Sutyawan IWE, Surasmiati NMA, Sarsono MC. Comparative efficacy and safety of intravitreal anti-VEGF therapy versus laser photocoagulation in treatment-requiring retinopathy of prematurity. Ophthatherapy [Internet]. 3 sierpień 2026 [cytowane 4 sierpień 2026];00:A0014. Dostępne na: https://www.journalsmededu.pl/index.php/ophthatherapy/article/view/3455
Numer
Dział
Chirurgia i laseroterapia
Utwór dostępny jest na licencji Creative Commons Uznanie autorstwa – Użycie niekomercyjne – Bez utworów zależnych 4.0 Międzynarodowe.
Copyright: Medical Education sp. z o.o. License allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)
Bibliografia
1. Wang WD, Yao YH, Lan CH et al. Impact of anti-VEGF therapy versus laser therapy on mortality and treatment outcomes in retinopathy of prematurity: A systematic review and meta-analysis. Acta Ophthalmol. 2026; 104(1): e1-17.
2. Mintz-Hittner HA, Kennedy KA, Chuang AZ. Efficacy of Intravitreal Bevacizumab for Stage 3+ Retinopathy of Prematurity. N Engl J Med. 2011; 364(7): 603-15.
3. Marra KV, Chen JS, Nudleman E et al. Review of Retinopathy of Prematurity Management in the Anti-VEGF Era: Evolving Global Paradigms, Persistent Challenges and Our AI-Assisted Future. Clin Exp Ophthalmol. 2025; 53(9): 1202-17.
4. Chiang MF, Quinn GE, Fielder AR et al. International Classification of Retinopathy of Prematurity, Third Edition. Ophthalmology. 2021; 128(10): e51-68.
5. Süren E, Özkaya D, Çetinkaya E et al. Comparison of bevacizumab, ranibizumab and aflibercept in retinopathy of prematurity treatment. Int Ophthalmol. 2022; 42(6): 1905-13.
6. Chang E, Josan AS, Purohit R et al. A Network Meta-Analysis of Retreatment Rates following Bevacizumab, Ranibizumab, Aflibercept, and Laser for Retinopathy of Prematurity. Ophthalmology. 2022; 129(12): 1389-401.
7. Stahl A, Lepore D, Fielder A et al. Ranibizumab versus laser therapy for the treatment of very low birthweight infants with retinopathy of prematurity (RAINBOW): an open-label randomised controlled trial. Lancet. 2019; 394(10208): 1551-9.
8. Stahl A, Sukgen EA, Wu WC et al. Effect of Intravitreal Aflibercept vs Laser Photocoagulation on Treatment Success of Retinopathy of Prematurity: The FIREFLEYE Randomized Clinical Trial. JAMA. 2022; 328(4): 348-59.
9. Wang AT, Gupta I, Dai S. A Review of Refractive Errors Post Anti-Vascular Endothelial Growth Factor Injection and Laser Photocoagulation Treatment for Retinopathy of Prematurity. J Clin Med. 2025; 14(3): 810.
10. Wu WC, Shih CP, Lien R et al. Serum vascular endothelial growth factor after bevacizumab or ranibizumab treatment for retinopathy of prematurity. Retina. 2017; 37(4): 694-701.
11. Chen J, Hao Q, Zhang J et al. The efficacy and ocular safety following aflibercept, conbercept, ranibizumab, bevacizumab, and laser for retinopathy of prematurity: a systematic review and meta-analysis. Ital J Pediatr. 2023; 49(1): 136.
12. Baiad AA, Sun C, Yin GS et al. A Meta-Analysis of Intravitreal Ranibizumab versus Laser Photocoagulation for the Treatment of Retinopathy of Prematurity. Ophthalmol Retina. 2025; 9(7): 677-89.
13. Taher N, Ghaddaf A, Al-Ghamdi S et al. Intravitreal Anti-vascular Endothelial Growth Factor Injection for Retinopathy of Prematurity: A Systematic Review and Meta-Analysis. Frontiers in Medicine 2022; 9: 884608.
14. Sitanggang R, Pradjnadewi S. What are the most effective medical interventions for managing retinopathy of prematurity in preterm infants born? A Systematic Review. The International Journal of Medical Science and Health Research 2025; 14(3): 1-50.
15. Ortiz-Seller A, Martorell P, Barranco H et al. Comparison of different agents and doses of anti-vascular endothelial growth factors (aflibercept, bevacizumab, conbercept, ranibizumab) versus laser for retinopathy of prematurity: A network meta analysis. Surv Ophthalmol. 2024; 69(4): 585-605.
16. Linghu D, Cheng Y, Zhu X et al. Comparison of Intravitreal Anti-VEGF Agents With Laser Photocoagulation for Retinopathy of Prematurity of 1,627 Eyes in China. Front Med. 2022; 9: 911095.
17. Tsiropoulos G, Seliniotaki A, Haidich A et al. Comparison of adverse events between intravitreal anti-VEGF and laser photocoagulation for treatment-requiring retinopathy of prematurity: a systematic review. Int Ophthalmol. 2022; 43: 1027-62.
18. Seery C, Betesh S, Guo S et al. Update on the Use of Anti-VEGF Drugs in the Treatment of Retinopathy of Prematurity. J Pediatr Ophthalmol Strabismus. 2020; 57(6): 351-62.
19. Gundlach BS, Kokhanov A, Altendahl M et al. Real-World Visual Outcomes of Laser and Anti-VEGF Treatments for Retinopathy of Prematurity. Am J Ophthalmol. 2022; 238: 86-96.
20. Murakami T, Okamoto F, Kinoshita T et al. Comparison of long-term treatment outcomes of laser and anti VEGF therapy in retinopathy of prematurity: a multicentre study from J-CREST group. Eye. 2023; 37(17): 3589-95.
21. VanderVeen D, Melia M, Yang M et al. Anti-Vascular Endothelial Growth Factor Therapy for Primary Treatment of Type 1 Retinopathy of Prematurity: A Report by the American Academy of Ophthalmology. Ophthalmology. 2017; 124(5): 619-33.
22. Barry GP, Yu Y, Ying GS et al.; G-ROP Study Group. Retinal Detachment after Treatment of Retinopathy of Prematurity with Laser versus Intravitreal Anti-Vascular Endothelial Growth Factor. Ophthalmology. 2021; 128(8): 1188-96.
2. Mintz-Hittner HA, Kennedy KA, Chuang AZ. Efficacy of Intravitreal Bevacizumab for Stage 3+ Retinopathy of Prematurity. N Engl J Med. 2011; 364(7): 603-15.
3. Marra KV, Chen JS, Nudleman E et al. Review of Retinopathy of Prematurity Management in the Anti-VEGF Era: Evolving Global Paradigms, Persistent Challenges and Our AI-Assisted Future. Clin Exp Ophthalmol. 2025; 53(9): 1202-17.
4. Chiang MF, Quinn GE, Fielder AR et al. International Classification of Retinopathy of Prematurity, Third Edition. Ophthalmology. 2021; 128(10): e51-68.
5. Süren E, Özkaya D, Çetinkaya E et al. Comparison of bevacizumab, ranibizumab and aflibercept in retinopathy of prematurity treatment. Int Ophthalmol. 2022; 42(6): 1905-13.
6. Chang E, Josan AS, Purohit R et al. A Network Meta-Analysis of Retreatment Rates following Bevacizumab, Ranibizumab, Aflibercept, and Laser for Retinopathy of Prematurity. Ophthalmology. 2022; 129(12): 1389-401.
7. Stahl A, Lepore D, Fielder A et al. Ranibizumab versus laser therapy for the treatment of very low birthweight infants with retinopathy of prematurity (RAINBOW): an open-label randomised controlled trial. Lancet. 2019; 394(10208): 1551-9.
8. Stahl A, Sukgen EA, Wu WC et al. Effect of Intravitreal Aflibercept vs Laser Photocoagulation on Treatment Success of Retinopathy of Prematurity: The FIREFLEYE Randomized Clinical Trial. JAMA. 2022; 328(4): 348-59.
9. Wang AT, Gupta I, Dai S. A Review of Refractive Errors Post Anti-Vascular Endothelial Growth Factor Injection and Laser Photocoagulation Treatment for Retinopathy of Prematurity. J Clin Med. 2025; 14(3): 810.
10. Wu WC, Shih CP, Lien R et al. Serum vascular endothelial growth factor after bevacizumab or ranibizumab treatment for retinopathy of prematurity. Retina. 2017; 37(4): 694-701.
11. Chen J, Hao Q, Zhang J et al. The efficacy and ocular safety following aflibercept, conbercept, ranibizumab, bevacizumab, and laser for retinopathy of prematurity: a systematic review and meta-analysis. Ital J Pediatr. 2023; 49(1): 136.
12. Baiad AA, Sun C, Yin GS et al. A Meta-Analysis of Intravitreal Ranibizumab versus Laser Photocoagulation for the Treatment of Retinopathy of Prematurity. Ophthalmol Retina. 2025; 9(7): 677-89.
13. Taher N, Ghaddaf A, Al-Ghamdi S et al. Intravitreal Anti-vascular Endothelial Growth Factor Injection for Retinopathy of Prematurity: A Systematic Review and Meta-Analysis. Frontiers in Medicine 2022; 9: 884608.
14. Sitanggang R, Pradjnadewi S. What are the most effective medical interventions for managing retinopathy of prematurity in preterm infants born? A Systematic Review. The International Journal of Medical Science and Health Research 2025; 14(3): 1-50.
15. Ortiz-Seller A, Martorell P, Barranco H et al. Comparison of different agents and doses of anti-vascular endothelial growth factors (aflibercept, bevacizumab, conbercept, ranibizumab) versus laser for retinopathy of prematurity: A network meta analysis. Surv Ophthalmol. 2024; 69(4): 585-605.
16. Linghu D, Cheng Y, Zhu X et al. Comparison of Intravitreal Anti-VEGF Agents With Laser Photocoagulation for Retinopathy of Prematurity of 1,627 Eyes in China. Front Med. 2022; 9: 911095.
17. Tsiropoulos G, Seliniotaki A, Haidich A et al. Comparison of adverse events between intravitreal anti-VEGF and laser photocoagulation for treatment-requiring retinopathy of prematurity: a systematic review. Int Ophthalmol. 2022; 43: 1027-62.
18. Seery C, Betesh S, Guo S et al. Update on the Use of Anti-VEGF Drugs in the Treatment of Retinopathy of Prematurity. J Pediatr Ophthalmol Strabismus. 2020; 57(6): 351-62.
19. Gundlach BS, Kokhanov A, Altendahl M et al. Real-World Visual Outcomes of Laser and Anti-VEGF Treatments for Retinopathy of Prematurity. Am J Ophthalmol. 2022; 238: 86-96.
20. Murakami T, Okamoto F, Kinoshita T et al. Comparison of long-term treatment outcomes of laser and anti VEGF therapy in retinopathy of prematurity: a multicentre study from J-CREST group. Eye. 2023; 37(17): 3589-95.
21. VanderVeen D, Melia M, Yang M et al. Anti-Vascular Endothelial Growth Factor Therapy for Primary Treatment of Type 1 Retinopathy of Prematurity: A Report by the American Academy of Ophthalmology. Ophthalmology. 2017; 124(5): 619-33.
22. Barry GP, Yu Y, Ying GS et al.; G-ROP Study Group. Retinal Detachment after Treatment of Retinopathy of Prematurity with Laser versus Intravitreal Anti-Vascular Endothelial Growth Factor. Ophthalmology. 2021; 128(8): 1188-96.