Comparison of Outcomes Between Combined Sparing Laser Photocoagulation and Intravitreal Bevacizumab Treatment Versus Conventional Laser Photocoagulation in Aggressive Posterior Retinopathy of Prematurity

Purpose: To report the clinical outcomes of combined sparing laser photocoagulation and intravitreal bevacizumab treatment compared to conventional laser photocoagulation for the treatment of aggressive posterior retinopathy of prematurity (APROP). Methods: A medical chart review was performed on all consecutive eyes with APROP that were treated with conventional laser photocoagulation or laser photocoagulation and intravitreal bevacizumab (IVB) injection between July 2019 and August 2020. The data were recorded for time to reversal of plus disease, time to total regression of retinopathy of prematurity (ROP) after intervention, total laser spots and area, proportion of eyes with satisfactory anatomical outcomes, and adverse events. Outcomes of the two groups were compared. Results: Sixteen eyes of 8 infants with APROP were included in the analysis. Eight eyes of 4 infants received combined sparing laser photocoagulation and IVB treatment, and 8 eyes of 4 infants received conventional laser photocoagulation. All 8 eyes in the combined treatment group and 6 of 8 eyes in the conventional treatment group showed regression of ROP with a satisfactory anatomical outcome. The average time to total regression of ROP was 34 days in the combined treatment group and 56 days in the conventional treatment group (P = .005). The number of laser spots was significantly lower in the combined treatment group (P= .03). Conclusions: Combined sparing laser photocoagulation and IVB treatment for eyes with APROP achieved ROP regression twice as fast, had fewer laser spots, and had a satisfactory anatomical outcome in comparison to conventional laser photocoagulation.