Ophthalmology science · 2026
Neurodevelopmental Disorders in Infants Treated with Anti-VEGF Agents versus Laser Photocoagulation or Cryotherapy for Retinopathy of Prematurity.
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Ben Ghezala Inès, Bonnet Caroline, Conese Caroline, Hassine Amir, Luu Maxime, Creuzot-Garcher Catherine, Bardou Marc
Аннотация
OBJECTIVE: To compare the incidence of early neurodevelopmental disorders in very preterm infants treated with intravitreal anti-VEGF agents versus laser photocoagulation and/or cryotherapy for retinopathy of prematurity (ROP).
DESIGN: Nationwide population-based retrospective cohort study.
PARTICIPANTS: All very preterm newborns (gestational age <32 weeks) born in France between 2015 and 2022 who received treatment for ROP with anti-VEGF agents, laser photocoagulation, or cryotherapy within the first 24 weeks of life.
METHODS: Using the French National Health Data System (Système National des Données de Santé), a medico-administrative database, we compared the incidence of early neurodevelopmental disorders between newborns treated with anti-VEGF agents and those treated with laser photocoagulation and/or cryotherapy, applying a propensity score‑weighted logistic regression model with inverse probability of treatment weighting.
MAIN OUTCOME MEASURES: Incidence of early neurodevelopmental disorders within the first 6 years of life.
RESULTS: The number of infants treated exclusively with anti-VEGF agents increased by 300% from 2015 to 2022. The primary comparative analysis was conducted on 102 newborns born between 2015 and 2019, for whom mother-infant linkage was available in the Système National des Données de Santé: 59 treated with anti-VEGF agents and 43 with laser and/or cryotherapy. Early neurodevelopmental disorders within the first 6 years of life were not observed more frequently in infants treated with anti-VEGF agents than in those treated with laser and/or cryotherapy (71.4% vs. 58.1%; odds ratio, 1.4; 95% confidence interval, 0.8-2.4; P = 0.31).
CONCLUSIONS: Using intravitreal anti-VEGF agents in very preterm newborns did not increase the risk of early neurodevelopmental disorders within the first 6 years of life. While a small excess risk cannot be formally excluded, these results might be reassuring for clinical practice, particularly given the substantial increase in the use of anti-VEGF agents for the treatment of ROP in recent years.
FINANCIAL DISCLOSURES: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
DESIGN: Nationwide population-based retrospective cohort study.
PARTICIPANTS: All very preterm newborns (gestational age <32 weeks) born in France between 2015 and 2022 who received treatment for ROP with anti-VEGF agents, laser photocoagulation, or cryotherapy within the first 24 weeks of life.
METHODS: Using the French National Health Data System (Système National des Données de Santé), a medico-administrative database, we compared the incidence of early neurodevelopmental disorders between newborns treated with anti-VEGF agents and those treated with laser photocoagulation and/or cryotherapy, applying a propensity score‑weighted logistic regression model with inverse probability of treatment weighting.
MAIN OUTCOME MEASURES: Incidence of early neurodevelopmental disorders within the first 6 years of life.
RESULTS: The number of infants treated exclusively with anti-VEGF agents increased by 300% from 2015 to 2022. The primary comparative analysis was conducted on 102 newborns born between 2015 and 2019, for whom mother-infant linkage was available in the Système National des Données de Santé: 59 treated with anti-VEGF agents and 43 with laser and/or cryotherapy. Early neurodevelopmental disorders within the first 6 years of life were not observed more frequently in infants treated with anti-VEGF agents than in those treated with laser and/or cryotherapy (71.4% vs. 58.1%; odds ratio, 1.4; 95% confidence interval, 0.8-2.4; P = 0.31).
CONCLUSIONS: Using intravitreal anti-VEGF agents in very preterm newborns did not increase the risk of early neurodevelopmental disorders within the first 6 years of life. While a small excess risk cannot be formally excluded, these results might be reassuring for clinical practice, particularly given the substantial increase in the use of anti-VEGF agents for the treatment of ROP in recent years.
FINANCIAL DISCLOSURES: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.