A comparison of primary laser versus laser after anti-vascular endothelial growth factor for type 1 retinopathy of prematurity

Abstract

Purpose: To compare characteristics of laser treatment for high-risk type 1 retinopathy of prematurity (ROP) in eyes treated with primary laser versus laser after an initial treatment with intravitreal anti-vascular endothelial growth factor (anti-VEGF).

Methods: The medical records of consecutive patients at a single academic institution treated for type 1 ROP before 36 weeks' postmenstrual age with primary laser versus laser after initial treatment with anti-VEGF were reviewed retrospectively. Outcome measures were laser spot number, mean laser power, total laser energy (Joules), and retinal vascularization to the nasal ora at time of laser treatment.

Results: Compared with the 46 eyes treated with primary laser, the 46 eyes treated with laser after anti-VEGF required fewer spots (mean, 775 vs 1418 [P < 0.01]), less power (182 vs 223 mW [P < 0.01]), and less total energy (27 vs 61 Joules [P < 0.01]), and showed greater vascularization to the nasal ora at the time of laser treatment (47.8% vs 6.5% [P < 0.01]).

Conclusions: In our study cohort, laser after initial anti-VEGF treatment may have allowed for greater retinal vascularization and been less destructive than primary laser for high-risk type 1 ROP.