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Rates, Timing, and Predictors of Retreatment Across Risk-Cohorts in Retinopathy of Prematurity: Intravitreal
Francisco Altamirano1, Melissa Yuan2, Celine Chaaya3
1From the Department of Ophthalmology (F.A., M.Y., S.H., J.H.J., R.A., I.S.M., C.W., E.G., D.K.V., R.G., N.A.P.), Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
American Journal of Ophthalmology
|June 27, 2026
Summary
Retreatment for retinopathy of prematurity (ROP) was low, especially with intravitreal bevacizumab. Aggressive ROP and laser treatment were linked to earlier retreatment needs in premature infants.
Area of Science:
- Ophthalmology
- Neonatology
- Pediatric Medicine
Background:
- Retinopathy of prematurity (ROP) is a leading cause of vision impairment in premature infants.
- Treatment-warranted ROP (TW-ROP) requires timely intervention to prevent vision loss.
- Comparing laser photocoagulation and intravitreal bevacizumab for ROP retreatment is crucial.
Purpose of the Study:
- To analyze the rates, timing, and predictors of retreatment for ROP.
- To compare retreatment outcomes between primary laser and intravitreal bevacizumab treatments.
- To identify factors influencing the need for ROP retreatment.
Main Methods:
- A retrospective, consecutive, comparative clinical study.
- Included infants treated for TW-ROP with primary laser or intravitreal bevacizumab (2017-2023).
- Assessed retreatment within 90 days, categorized as early (≤30 days) or late (31-90 days).
Main Results:
- Overall retreatment rate was 18.2% (33/181 eyes), exclusively in micro/nano-premature infants (<27 weeks GA and/or <800g).
- Early retreatment (≤30 days) occurred in 8.8% of eyes, with significantly higher rates in the laser group (21.5%) vs. bevacizumab group (1.7%).
- Bevacizumab group showed lower odds of overall and early retreatment, and a later postmenstrual age at retreatment compared to the laser group.
Conclusions:
- Early retreatment for ROP is infrequent, particularly with intravitreal bevacizumab.
- Aggressive ROP is a predictor of earlier retreatment, indicating more severe disease.
- Bevacizumab is associated with reduced retreatment rates and delayed intervention needs compared to laser therapy.
