Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus · 2026
Real-world outcomes of retinopathy of prematurity treated with primary laser versus primary anti-vascular endothelial growth factor and deferred laser.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Yuan Melissa, Hu Daniel, Altamirano Francisco, Hoyek Sandra, Chaaya Celine, Abidi Muhammad, De Bruyn Hanna, Fulton Anne, Mantagos Iason S, Wu Carolyn, Gonzalez Efren, VanderVeen Deborah K, Patel Nimesh A, Gise Ryan
Аннотация
PURPOSE: To compare visual and anatomic outcomes between primary laser photocoagulation and anti-vascular endothelial growth factor (VEGF) therapy with early or late deferred laser treatment (for reactivation or peripheral avascular retina [PAR]) in management of retinopathy of prematurity (ROP).
METHODS: In this retrospective cohort study, eyes were divided into three groups: primary laser, anti-VEGF with early (<4 months) deferred laser, and anti-VEGF with late (≥4 months) deferred laser (treated prophylactically for PAR per protocol or for reactivation if needed).
RESULTS: A total of 260 eyes of 139 patients treated for ROP between 2013 and 2023 were included: 159 eyes in the primary group, 20 in the early-deferred group, and 81 in the late-deferred group. The primary laser group was older at first treatment (median postmenstrual age, 39.1 weeks vs 36.1 and 35.7 weeks for early- and late-deferred laser groups [P < 0.01]). Zone 1 disease was more common in anti-VEGF groups (43%-45% vs 1.9% [P < 0.01]). At median follow-up of 35 months, visual acuity was better in the early-deferred laser group (logMAR 0.14) than in the primary laser (0.18) and late-deferred laser (0.18) groups (P < 0.001; 162 eyes of 91 patients). Retinal detachment rates were not significantly different (3.1% primary laser vs 0.0% in anti-VEGF groups [P = 0.31] when excluding 2 eyes of 1 patient with numerous missed examinations and an atypical follow-up schedule due to medical instability in the early deferred laser group). At 2 years, the early-deferred laser group was more myopic (median, -1.50 D vs 0.0 D and 0.50 D [P = 0.031]). There were no differences in adverse events, strabismus, or amblyopia (P > 0.05 for all).
CONCLUSIONS: Primary laser and anti-VEGF with deferred laser showed comparable anatomic outcomes. Refractive outcomes were comparable, though myopia was common in all groups. Anti-VEGF was more commonly used for posterior disease, reflecting contemporary practice patterns at this quaternary referral center.
METHODS: In this retrospective cohort study, eyes were divided into three groups: primary laser, anti-VEGF with early (<4 months) deferred laser, and anti-VEGF with late (≥4 months) deferred laser (treated prophylactically for PAR per protocol or for reactivation if needed).
RESULTS: A total of 260 eyes of 139 patients treated for ROP between 2013 and 2023 were included: 159 eyes in the primary group, 20 in the early-deferred group, and 81 in the late-deferred group. The primary laser group was older at first treatment (median postmenstrual age, 39.1 weeks vs 36.1 and 35.7 weeks for early- and late-deferred laser groups [P < 0.01]). Zone 1 disease was more common in anti-VEGF groups (43%-45% vs 1.9% [P < 0.01]). At median follow-up of 35 months, visual acuity was better in the early-deferred laser group (logMAR 0.14) than in the primary laser (0.18) and late-deferred laser (0.18) groups (P < 0.001; 162 eyes of 91 patients). Retinal detachment rates were not significantly different (3.1% primary laser vs 0.0% in anti-VEGF groups [P = 0.31] when excluding 2 eyes of 1 patient with numerous missed examinations and an atypical follow-up schedule due to medical instability in the early deferred laser group). At 2 years, the early-deferred laser group was more myopic (median, -1.50 D vs 0.0 D and 0.50 D [P = 0.031]). There were no differences in adverse events, strabismus, or amblyopia (P > 0.05 for all).
CONCLUSIONS: Primary laser and anti-VEGF with deferred laser showed comparable anatomic outcomes. Refractive outcomes were comparable, though myopia was common in all groups. Anti-VEGF was more commonly used for posterior disease, reflecting contemporary practice patterns at this quaternary referral center.