Comparison of intravitreal bevacizumab injection and laser photocoagulation for type 1 zone II retinopathy of prematurity

Roohipoor, Ramak; Torabi, Hamidreza; Karkhaneh, Reza; Riazi-Eafahani, Mohammad

doi:10.1016/j.joco.2018.10.008

Cited by 17 publications

(19 citation statements)

References 36 publications

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“…This meta-analysis included 579 infants (1,158 eyes) ( 1 , 3 , 10 , 11 , 13 , 15 , 16 ). Of them, 267 (534 eyes), 213 (426 eyes), and 99 (198 eyes) were randomly assigned to the laser therapy, IVB monotherapy, and IVR groups, respectively.…”

Section: Resultsmentioning

confidence: 99%

“…Five RCTs ( n = 820 eyes) reported data on ROP recurrence ( 1 , 3 , 11 , 13 , 16 ). No significant difference was noted between anti-VEGF monotherapy and laser photocoagulation therapy in recurrence rate (RR = 1.56, 95% CI 0.23–10.54, P = 0.65, I 2 = 87%).…”

Section: Resultsmentioning

confidence: 99%

“…Six RCTs ( n = 900 eyes) reported data on retreatment ( 1 , 10 , 11 , 13 , 15 , 16 ). Anti-VEGF injection and laser therapy showed similar retreatment rates (RR = 1.56, 95% CI 0.35–6.96, P = 0.56, I 2 = 59%).…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Six RCTs ( n = 1,170 eyes) reported data on adverse events ( 1 , 3 , 10 , 11 , 15 , 16 ). Overall, intravitreal anti-VEGF injection showed a significantly lower adverse event rate than retinal ablative therapy (RR = 0.17, 95% CI 0.07–0.44, P < 0.001, I 2 = 0%); myopic changes and unfavorable structural outcomes, such as macular ectopia and retinal folds, vitreous and retinal hemorrhages, and retinal detachment, were prevalent among the laser group ( 10 , 11 , 16 ). Similarly, a significantly higher adverse event rate was noted in the laser group than in the anti-VGEF injection group at zone I (RR = 0.06, 95% CI 0.01–0.43, P = 0.005, I 2 = not applicable) and zone II (RR = 0.28, 95% CI 0.08–0.94, P = 0.04, I 2 = 0%), but there was no significant difference between anti-VEGF injection and laser therapy in the undetermined zone subgroup (RR = 0.14, 95% CI 0.02–1.13, P = 0.07, I 2 = not applicable) ( Figure 11 ).…”

Section: Resultsmentioning

confidence: 99%

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Intravitreal Anti-vascular Endothelial Growth Factor Injection for Retinopathy of Prematurity: A Systematic Review and Meta-Analysis

et al. 2022

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BackgroundLaser photocoagulation and/or intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections constitute the current standard treatment for retinopathy of prematurity (ROP). This systematic review and meta-analysis aimed to assess the efficacy and safety of anti-VEGF monotherapy for ROP treatment using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.MethodsWe searched the Medline, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) databases. We included randomized controlled trials (RCTs) that compared intravitreal anti-VEGF monotherapy (e.g., bevacizumab, ranibizumab, aflibercept, and pegaptanib) with laser photocoagulation in preterm infants with ROP. We evaluated the rates of recurrence, treatment switching, retreatment, adverse events, and mortality. The risk ratio (RR) was used to represent dichotomous outcomes. Data were pooled using the inverse variance weighting method. The quality of evidence was assessed using the GRADE approach. Risk of bias was assessed using the Revised Cochrane risk of bias tool for randomized trials.ResultsSeven RCTs (n = 579; 1,158 eyes) were deemed eligible. Three RCTs had an overall low risk of bias, three had some concerns, and one had an overall high risk of bias. The pooled effect estimate showed a statistically significant reduction in adverse events in favor of anti-VEGF monotherapy [RR = 0.17, 95% confidence interval (CI) 0.07–0.44]. The pooled analysis showed no significant difference between the anti-VEGF and laser groups in terms of recurrence rate (RR = 1.56, 95% CI 0.23–10.54), treatment switching (RR = 2.92, 95% CI 0.40–21.05), retreatment (RR = 1.56, 95% CI 0.35–6.96), and mortality rate (RR = 1.28, 95% CI 0.48–3.41).ConclusionOverall, intravitreal anti-VEGF monotherapy was associated with fewer adverse events than laser therapy, rated as high quality of evidence according to the GRADE criteria. Pooled analysis revealed no significant difference between the two arms with respect to the recurrence rate, treatment switching, retreatment, and mortality rate, with quality of evidence ranging from moderate to very low as per the GRADE approach.Systematic Review Registration[https://www.crd.york.ac.uk/prospero/#recordDetails], identifier [CRD42021270077].

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Intravitreal Anti-vascular Endothelial Growth Factor Injection for Retinopathy of Prematurity: A Systematic Review and Meta-Analysis

et al. 2022

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Efficacy comparison of anti-vascular endothelial growth factor drugs for the treatment of type 1 retinopathy of prematurity: A network meta-analysis of randomised controlled trials

Zhou,

Hashimoto,

Liu

et al. 2023

Graefes Arch Clin Exp Ophthalmol

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Comparison of adverse events between intravitreal anti-VEGF and laser photocoagulation for treatment-requiring retinopathy of prematurity: a systematic review

et al. 2022

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Purpose To synthesize existing evidence on adverse events, complications, and unfavorable outcomes of current treatment modalities for treatment-requiring retinopathy of prematurity (TR-ROP). Methods PubMed, Cochrane Central Register of Controlled Trials, Scopus, EMBASE, Trip Database, and the gray literature available were searched. Randomized Clinical Trials and observational studies comparing the adverse events of intravitreal anti-VEGF injections (bevacizumab, ranibizumab, aflibercept, pegaptanib, conbercept) and laser photocoagulation (LPC) as treatment modalities for infants with TR-ROP were included. The main outcomes compared between the two treatment modalities were: 1. Refractive Errors and Biometry Parameters, 2. Adverse events, complications, and unfavorable outcomes, 3. Disease Recurrence/Disease Regression/Need for retreatment, 4. Neurodevelopmental Outcomes. Results Higher quality studies concluded that LPC leads to greater rates of myopia than intravitreal anti-VEGF treatment while the rate of adverse events and of unfavorable neurodevelopmental outcomes is similar. However, there was controversy among the included studies concerning the rate of ROP recurrence between intravitreal anti-VEGF injections and LPC. Conclusion There is need for future primary studies assessing the adverse events of intravitreal anti-VEGF injections compared with LPC as treatment modalities for infants with TR-ROP.

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Comparison of intravitreal bevacizumab injection and laser photocoagulation for type 1 zone II retinopathy of prematurity

Cited by 17 publications

References 36 publications

Intravitreal Anti-vascular Endothelial Growth Factor Injection for Retinopathy of Prematurity: A Systematic Review and Meta-Analysis

Intravitreal Anti-vascular Endothelial Growth Factor Injection for Retinopathy of Prematurity: A Systematic Review and Meta-Analysis

Efficacy comparison of anti-vascular endothelial growth factor drugs for the treatment of type 1 retinopathy of prematurity: A network meta-analysis of randomised controlled trials

Comparison of adverse events between intravitreal anti-VEGF and laser photocoagulation for treatment-requiring retinopathy of prematurity: a systematic review

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