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Laser versus Anti-VEGF: A Paradigm Shift for Treatment-Warranted Retinopathy of Prematurity

M Elizabeth Hartnett1, Andreas Stahl2

  • 1Byers Eye Institute at Stanford University, Stanford University, 2452 Watson Court, Palo Alto, CA, 94303, USA. me.hartnett@stanford.edu.

Ophthalmology and Therapy
|June 19, 2023
PubMed

Insights

Retinopathy of prematurity (ROP) causes childhood blindness due to abnormal blood vessel growth. Current treatments focus on laser therapy and anti-VEGF injections to manage this condition.

Area of Science:

  • Ophthalmology
  • Neonatology
  • Vascular Biology

Background:

  • Retinopathy of prematurity (ROP) is a primary cause of childhood blindness.
  • Historically, ROP was linked to retinal neovascularization and detachment.
  • Modern understanding includes insufficient vascular growth in early ROP stages, especially with premature infant survival.

Purpose of the Study:

  • To review the evolving understanding and current management of retinopathy of prematurity.
  • To highlight the established and emerging treatment strategies for ROP.

Main Methods:

  • Literature review of ROP pathogenesis and treatment evolution.
  • Analysis of historical and current treatment modalities for ROP.

Main Results:

  • ROP understanding has expanded beyond neovascularization to include early vascular underdevelopment.
  • Two primary treatments exist: laser photocoagulation (standard since the 1990s) and anti-VEGF injections (since 2007).

Conclusions:

  • Managing vasoproliferation in ROP remains critical for treatment-warranted eyes.
  • Laser treatment and anti-VEGF injections are the current mainstays of ROP management.

Keywords:
Anti-VEGFLaserROPRetinopathy of prematurityVitreoretinal surgery

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