Laser therapy versus intravitreal injection of anti-VEGF agents in monotherapy of ROP: a Meta-analysis
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Guo-Ming Zhang. Shenzhen Eye Hospital, Shenzhen Key Ophthalmic Laboratory, the Second Affiliated Hospital of Jinan University, 18 Zetian Road, Shenzhen 518040, Guangdong Province, China. 13823509060@163.com

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Supported by the Basic Discipline Layout Foundation of the Shenzhen Science and Innovation Commission (No.JCYJ20170817112542555).

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    Abstract:

    AIM: To compare the efficacy and safety between laser therapy and anti-vascular endothelial growth factor (VEGF) agents intravitreal injection monotherapy in type-1 retinopathy of prematurity (ROP) and aggressive posterior retinopathy of prematurity (APROP). METHODS: A systematic literature search was performed in PubMed, Cochrane Library, and Embase for original comparable studies. We included studies that compare laser therapy and intravitreal injections of anti-VEGF agents monotherapy in ROP regardless of languages and publication types. RESULTS: Complication incidence was significantly higher in laser therapy group (OR: 0.38; 95%CI: 0.19-0.75; P=0.005). Spherical equivalent (SE) was higher in laser therapy [weighted mean difference (WMD): 2.40, 95%CI: 0.88-3.93; P=0.002]. The time between treatment and retreatment was longer in laser therapy group (WMD: 8.45, 95%CI: 5.35-11.55; P<0.00001). Recurrence incidence (OR: 0.97; 95%CI: 0.45-2.09; P=0.93) and retreatment incidence (OR: 1.24; 95%CI: 0.56-2.73; P=0.59) were similar in two approaches. Subgroup analysis between type-1 ROP and APROP was not significant except SE reported in the included studies (P<0.0001). CONCLUSION: This Meta-analysis outcome indicates anti-VEGF agents are as effective as laser treatment, and safer than laser in type-1 ROP and APROP. The degree of myopia in APROP is higher than type-1 ROP. More randomized controlled trials in large sample size should be conducted in the future.

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Shi-Dan Wang, Guo-Ming Zhang, Shenzhen Screening for Retinopathy of Prematurity Cooperative Group. Laser therapy versus intravitreal injection of anti-VEGF agents in monotherapy of ROP: a Meta-analysis. Int J Ophthalmol, 2020,13(5):806-815

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Publication History
  • Received:June 03,2019
  • Revised:November 21,2019
  • Adopted:
  • Online: March 30,2020
  • Published: