Trends in the Initial Treatment for Retinopathy of Prematurity in the United States

The aim of this study was to characterize trends in choice of initial therapy for retinopathy of prematurity (ROP) in the United States.

This is a cross-sectional time-series analysis on infants diagnosed with ROP categorized by initial treatment modality (laser photocoagulation/cryotherapy or intravitreal injection). TriNetX was used for data collection, and Cochran-Armitage trend tests were used to evaluate changes in the proportion of treatment modalities and agent usage over time.

A total of 2,050 infants met inclusion criteria. The proportion of infants treated with laser/cryotherapy decreased from 100% to 62.7% (P < .0001). Bevacizumab decreased from 100% of all intravitreal injections to 76.7% (P < .0001). Aflibercept use increased from 0% to 18.8% (P < .0001). White infants were more likely to be treated with intravitreal anti-VEGF than Black or Hispanic infants (P = .0061).

The rates of anti-VEGF for initial treatment have been rising over the years; however, laser photocoagulation remains the most common treatment for ROP in the United States.