Complications of retinopathy of prematurity treatment : Current Opinion in Ophthalmology

Secondary Logo

Journal Logo

RETINOPATHY OF PREMATURITY: NICU TO ADULTHOOD: Edited by Audina Berrocal and Antonio Capone Jr.

Complications of retinopathy of prematurity treatment

Barnett, Joshua M.; Hubbard, G. Baker

Author Information
Current Opinion in Ophthalmology 32(5):p 475-481, September 2021. | DOI: 10.1097/ICU.0000000000000783


Purpose of review 

The purpose of this review is to summarize complications of treatment for retinopathy of prematurity (ROP) and to compare complications of laser and intravitreal antivascular endothelial growth factor (VEGF) injections.

Recent findings 

Poor structural outcomes and myopia are more common with laser for severe ROP than with anti-VEGF. Clinical trial data show unfavourable outcomes in 9.1–9.5% of laser treated, and 1.4–3.6% of anti-VEGF treated eyes. Additional randomized trial data show risk for very high myopia (≥-8.00D) to be 3.8 and 51.4% for zone I eyes treated with bevacizumab and laser, respectively. However, anti-VEGF may be complicated by late recurrence and is more likely to require retreatment than laser. Laser often necessitates general anaesthesia with its attendant risks, including worse short-term respiratory outcomes. Neurodevelopmental complications have been reported with anti-VEGF, but existing studies are subject to bias.


Treatment complications are substantially different for the two modalities in common use today. In more severe cases, risk of poor structural outcome and myopia favour treatment with anti-VEGF. In less severe ROP, risk of recurrence and the need for additional treatments may favour laser. Additional data are needed to establish comparative risks of neurodevelopmental complications.

Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

You can read the full text of this article if you:

Access through Ovid