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. 2020 May 18;13(5):806-815.
doi: 10.18240/ijo.2020.05.17. eCollection 2020.

Laser therapy versus intravitreal injection of anti-VEGF agents in monotherapy of ROP: a Meta-analysis

Shi-Dan Wang  1 , Guo-Ming Zhang  1 ; Shenzhen Screening for Retinopathy of Prematurity Cooperative Group
Affiliations

Laser therapy versus intravitreal injection of anti-VEGF agents in monotherapy of ROP: a Meta-analysis

Shi-Dan Wang et al. Int J Ophthalmol. .

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.

Keywords: Meta-analysis; anti-vascular endothelial growth factor; bevacizumab; laser therapy; ranibizumab; recurrence; retinopathy of prematurity.

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Figures

Figure 1
Figure 1. Search strategy.
Figure 2
Figure 2. Quality assessment of randomized controlled trials
For each quality domain, the proportions of included studies that suggest low, high, or unclear risk of bias and/or concerns regarding applicability are displayed in green, yellow, and red, respectively.
Figure 3
Figure 3. Complication comparison outcomes following laser therapy versus anti-VEGF agents intravitreal injection monotherapy for ROP.
Figure 4
Figure 4. SE comparison outcomes following laser therapy versus anti-VEGF agents intravitreal injection monotherapy for ROP.
Figure 5
Figure 5. Recurrence comparison outcomes following laser therapy versus anti-VEGF agents intravitreal injection monotherapy for ROP.
Figure 6
Figure 6. Retreatment incidence comparison outcomes following laser therapy versus anti-VEGF agents intravitreal injection monotherapy for ROP.
Figure 7
Figure 7. Time between treatment and retreatment outcomes following laser therapy versus anti-VEGF agents intravitreal injection monotherapy for ROP.
Figure 8
Figure 8. Beggs's funnel plot for assessing publication bias.
See this image and copyright information in PMC

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