The following article is a part of conference coverage from the American Academy of Ophthalmology 2020, being held virtually from November 13 to 15, 2020. The team at Ophthalmology Advisor will be reporting on the latest news and research conducted by leading experts in ophthalmology. Check back for more from the AAO 2020.

Differences in time to re-treatment, surgical intervention rates, and additional treatment needs should be considered when managing retinopathy of prematurity through either intravitreal injections or laser photocoagulation. Data comparing these treatments were presented at the American Academy of Ophthalmology 2020 annual meeting, held virtually from November 13 to November 15, 2020. 

Both laser photocoagulation and anti-vascular endothelial growth factor (VEGF) intravitreal injections can be considered to treat retinopathy of prematurity; however, the comparative efficacy and safety of these treatment modalities remain unclear. Investigators conducted a meta-analysis of studies reporting outcomes for these procedures; the primary outcome was regression rate, with secondary outcomes including likelihood of further treatment, visual acuity, and complication rates. 

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In total the investigators took into account 24 articles. Within these studies, 1289 eyes received intravitreal injections and 2412 underwent laser photocoagulation. Between the 2 groups, regression rates, visual acuity, and safety outcomes were “non-significantly different” (P =.68, P =1.00, and P ≥.18, respectively). 

Eyes that received intravitreal injections were more likely to require additional treatment (P =.005), but less frequently required surgical intervention (P =.02). Intravitreal injections were also associated with a longer time from treatment to either re-treatment or recurrence (P =.002). 

“[Laser photocoagulation] eyes require additional treatment less often, while [intravitreal injections] are associated with a longer time to re-treatment/recurrence and a lower surgical intervention rate,” the researchers concluded. “These important differences should be considered when managing [retinopathy of prematurity].”

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Nichani P, Popovic M, Muni RH, Mireskandari K, Tehrani NN, Kertes PJ. Intravitreal injections vs laser photocoagulation for ROP: A meta-analysis of 3,701 eyes. Presented at: American Academy of Ophthalmology 2020 Annual Meeting; November 13-15, 2020. Abstract PO431.