Objective: To compare the success and reactivation rates between laser photocoagulation and intravitreal anti-VEGF injection for the treatment of retinopathy of prematurity (ROP).
Materials and Methods: A total of 434 patients with ROP were included in the study, with 299 treated with laser photocoagulation (group 1) and 135 treated with intravitreal anti-VEGF injection (group 2). Outcome measures included birth weight, gestational age, disease stage, presence of plus disease, type of first intervention, time of postpartum ROP onset, date and time of recurrence after the first intervention, type of second intervention following recurrence, and sex.
Results: Laser photocoagulation (LP) was performed in 299 premature patients, and intravitreal anti-VEGF injection was the first intervention in 135 patients. The overall reactivation rate for ROP after treatment was 6.5% (n = 28). The reactivation rates for group 1 and group 2 were 3.7% (n = 11) and 12.6% (n = 17), respectively, with the difference being significant (p < 0.001). Over the past 11 years, there has been a shift from laser treatment to anti-VEGF therapy, with anti-VEGF therapy linked to a 3.77-fold higher risk of reactivation. Low birth weight, small for gestational age, and aggressive posterior ROP were identified as factors contributing to an elevated risk of reactivation. The median time to reactivation was similar for both group 1 and group 2 patients (p > 0.05).
Conclusion: Both laser application and anti-VEGF injection were effective for the treatment of ROP. However, initial LP has a lower reactivation rate.