Refractive errors in premature infants with retinopathy of prematurity after anti-vascular endothelial growth factor (anti-VEGF) therapy

Vujanović, Milena; Stanković-Babić, Gordana; Oros, Ana; Zlatanović, Gordana; Jovanović, Predrag; Cekić, Sonja; Tomasevic, Branislav; Djordjević-Jocić, Jasmina

doi:10.2298/vsp150831191v

Cited by 5 publications

(6 citation statements)

References 25 publications

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“…Two articles 23 25 reported the LT, which did not differ significantly between the anti-VEGF drug and laser groups (MD=0.06 mm; 95% CI −0.56 to 0.67, p=0.85), and I 2 was 97% ( online supplemental material : S4 forest plot).…”

Section: Resultsmentioning

confidence: 99%

“…Three articles 23 25 26 reported the AL, with 251 eyes in the anti-VEGF drug group and 362 eyes in the control group ( figure 4 ). There was no significant difference in the AL between the groups (MD=−0.04 mm, 95% CI −0.30 to 0.21), and the heterogeneity was low (I 2 =30%).…”

Section: Resultsmentioning

confidence: 99%

“…Three articles 23 25 26 reported the ACD in children with ROP who were or were not taking anti-VEGF drugs. We found no difference in the ACD between the anti-VEGF drug and control groups (MD=0.19 mm; 95% CI −0.14 to 0.52, I 2 =85%; figure 5 ).…”

Section: Resultsmentioning

confidence: 99%

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Refractive outcomes after intravitreal injection of antivascular endothelial growth factor versus laser photocoagulation for retinopathy of prematurity: a meta-analysis

Kong

Ming

2021

BMJ Open

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ObjectiveTo determine the effects of the intraocular injection of antivascular endothelial growth factor (anti-VEGF) drugs on the refractive status of infants with retinopathy of prematurity (ROP).DesignSystematic review and meta-analysis of the refractive status of infants with ROP who receive anti-VEGF drugs.Data sourcesThe PubMed, Web of Science and Embase databases and the ClinicalTrials.gov website were searched up to June 2020.Eligibility criteria when selecting studiesWe included randomised controlled trials (RCTs) and observational studies that compared refractive errors between anti-VEGF drug and laser therapies.Data extraction and synthesisData extraction and risk-of-bias assessments were conducted by two independent reviewers. We used a random-effect model to pool outcomes. The outcome measures were the spherical equivalents, axial length (AL), anterior chamber depth (ACD) and lens thickness (LT).ResultsThirteen studies involving 1850 eyes were assessed: 914 in the anti-VEGF drug group, and 936 in the control (laser) group. Children who received anti-VEGF drug treatment had less myopia than those who received laser therapy (mean difference=1.80 D, 95% CI 0.97 to 2.63, p＜0.0001, I2=78%). The AL, ACD and LT did not reach statistical significance difference between the two groups. The current evidence indicates that the refractive safety in children with ROP is better for anti-VEGF drug treatment than for laser therapy.ConclusionsThis meta-analysis indicates that anti-VEGF drug therapy results in less myopia compared with laser therapy. However, there are relatively few published articles on refractive errors in ROP, and so high-quality and powerful RCTs are needed in the future.PROSPERO registration numberCRD42020160673.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Refractive outcomes after intravitreal injection of antivascular endothelial growth factor versus laser photocoagulation for retinopathy of prematurity: a meta-analysis

Kong

Ming

2021

BMJ Open

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“…However, nine papers, including 1046 eyes of 547 premature infants treated for ROP, reported similar refractive outcomes between the two treatment modalities (Table 1). In a study by Vujanovic et al [30], refractive astigmatism and high myopia were more common in the laser-treated eyes, and anisometropia was significantly greater than that in the anti-VEGF-treated eyes. Therefore, this study was included in the first category.…”

Section: Resultsmentioning

confidence: 91%

“…Some studies revealed comparable refractive outcomes between the two treatment modalities for ROP [9,16,23,30,[44][45][46][47][48]. The treatment type did not influence long-term refractive outcomes in ROP [44].…”

Section: Discussionmentioning

confidence: 99%

Refractive outcomes in infants treated for retinopathy of prematurity

Heidary¹,

Gharebaghi²

2022

Med Hypothesis Discov Innov Optom

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Background: Infants treated for retinopathy of prematurity (ROP) can develop visually significant refractive error. However, the degree of refractive error may differ between laser treatment and intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection. We reviewed studies that investigated refractive error outcomes of treatment in premature infants with ROP. Methods: In this narrative review, a literature search was carried out in PubMed/MEDLINE from 01/01/2000 to 20/10/2022 without language restrictions, using the following keywords: “anti-VEGF,” “ROP” or “prematurity retinopathy,” and “laser.” We included comparative studies on refractive error outcomes of intravitreal anti-VEGF and laser treatments, a combination of both modalities simultaneously or sequentially, and two anti-VEGF agents. Results: The initial search yielded 164 records. We reviewed the titles and abstracts of the retrieved papers and the reference list of published systematic reviews and meta-analyses, meta-analyses, or reviews on our topic. Thirty-three records fulfilled our inclusion criteria, which included refractive outcomes in 4350 eyes of 2359 participants treated for ROP. Based on the reported refractive outcomes, we divided the studies into four categories: 1) those that revealed a higher rate of refractive error in the laser-treated eyes than in the anti-VEGF-treated eyes; 2) those that revealed no significant difference in refractive outcomes between the two treatment modalities; 3) those that revealed a higher rate of refractive error in the anti-VEGF-treated eyes or compared refractive outcomes between two anti-VEGF agents; and 4) those that reported refractive outcomes in the eyes that received combined simultaneous or sequential treatment with laser after initial anti-VEGF treatment. We also summarized the refractive outcomes of all included primary studies in each category. Conclusions: This study showed that the laser-treated eyes experienced more myopic shift. However, the refractive outcomes in premature infants of laser treatment, anti-VEGF treatment, and a combination of both modalities simultaneously or sequentially were often contradictory. This variability resulted from obvious differences in the sample size, different follow-up durations, or inhomogeneous study or treatment designs. Further well-designed prospective trials on refractive outcomes and the trend of changes in the refractive status over long-term follow-ups in the eyes treated with ROP are necessary to identify consensus results concerning real-world refractive outcomes of each treatment modality or simultaneous or sequential combination of both modalities, to suggest a safe and effective treatment option for eye care professionals.

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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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Refractive errors in premature infants with retinopathy of prematurity after anti-vascular endothelial growth factor (anti-VEGF) therapy

Cited by 5 publications

References 25 publications

Refractive outcomes after intravitreal injection of antivascular endothelial growth factor versus laser photocoagulation for retinopathy of prematurity: a meta-analysis

Refractive outcomes after intravitreal injection of antivascular endothelial growth factor versus laser photocoagulation for retinopathy of prematurity: a meta-analysis

Refractive outcomes in infants treated for retinopathy of prematurity

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

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