Treatment method |
Laser ablation burns the peripheral retina to stop neovascularization. |
Anti-VEGF agent immediately bind to the VEGF in the vitreous cavity and retina. |
Administration |
Laser treatment is not easy to learn and it can last for 60–90 minutes. Treatment should be performed in a neonatal intensive care unit or an operating room equipped with an intubation unit. |
Intravitreal injections are performed aseptically under local anesthesia on awake infants at the bedside. |
Treatment response |
It may take one to 2 weeks for laser treatment to stop the progression of ROP. |
It starts working right away. Usually, regression occurs as early as 1–3 days. |
Follow-up periods |
Since the avascular peripheral retina was ablated, follow-up up to 50–55 weeks of postmenstrual age may be recommended. |
Long-term follow-up is required until retinal vascularization is complete. |
Recurrence |
Reactivation after laser ablation is uncommon. Most cases of reactivation may be related to skip area. |
Reactivation occurs more frequently after anti-VEFG injection. However, the degree of reactivation may vary depending on the severity of ROP, the type of anti-VEGF, and the injected dose. |
(=reactivation) |
Refractive error |
Myopia progression is larger and more rapid in children with ROP who received laser treatment than injection treatment. |
Two-year follow-up data from the BEAT-ROP study showed a significant decrease in the amount of myopia. |
Visual fields |
The wider the laser range, the more the peripheral visual field is disrupted. |
It offers the potential to provide a wider visual field with anti-VEGF than with laser, by giving the peripheral retina an opportunity for blood vessels to grow. |
Systemic effects |
Anesthesia-related problems and mortality may occur. |
VEGF is a necessary component for neural, vascular, and lung development. There is ongoing research to evaluate the long-term effects of VEGF suppression. |
Complications related to procedure |
Extensive laser ablation causes ocular inflammation and causes certain complications such as anterior segment ischemia or, rarely, laser-induced cataract formation. |
Intravitreal injection-related procedures can cause conjunctival hemorrhage, increased intraocular pressure, hyphemia, vitreous hemorrhage, cataract, and endophthalmitis. |