Comparison of 5-year safety and efficacy of laser photocoagulation and intravitreal bevacizumab injection in retinopathy of prematurity

Graefes Arch Clin Exp Ophthalmol. 2021 Sep;259(9):2849-2855. doi: 10.1007/s00417-021-05137-9. Epub 2021 Mar 21.


Purpose: To compare laser photocoagulation and intravitreal injection of bevacizumab (IVB) treatment for retinopathy of prematurity (ROP).

Methods: The study included 52 eyes of 26 patients after ROP treatment who were observed up to 5 years of age. Twenty-eight eyes received laser photocoagulation as the initial treatment (laser group), and twenty-four eyes underwent IVB (IVB group). We collected data on gestational age, birth weight, 1- and 5-min Apgar scores, zone and stage at the time of treatment, recurrence of ROP and best-corrected visual acuity (BCVA) (logMAR), equivalent spherical value (SE), ocular complications, and developmental delay at the age of 5.

Results: More zone I low-stage eyes were treated with IVB than laser. There was no difference in BCVA (p = 0.836). Although the mean SE was not different between the groups (p = 0.280), the prevalence of myopia was significantly higher in the laser group (p = 0.020). Developmental delay was observed in 3 of 14 and 3 of 12 cases in the laser and IVB groups, respectively (p = 0.596). Retinal holes were observed in 2 eyes in the IVB group, with 1 developing localized retinal detachment. There were no significant differences between the groups in the other factors.

Conclusions: Compared to laser for ROP, IVB was not inferior in neurodevelopment or visual outcome and was superior in refractive error. As cases in the IVB group showed retinal holes, long-term follow-up with fundus examination is recommended after IVB.

Keywords: Bevacizumab; IVB; ROP; Retinopathy of prematurity.

MeSH terms

  • Angiogenesis Inhibitors / therapeutic use
  • Bevacizumab / therapeutic use
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Intravitreal Injections
  • Laser Coagulation
  • Lasers
  • Retinopathy of Prematurity* / diagnosis
  • Retinopathy of Prematurity* / drug therapy
  • Retinopathy of Prematurity* / surgery
  • Retrospective Studies
  • Treatment Outcome
  • Vascular Endothelial Growth Factor A


  • Angiogenesis Inhibitors
  • Vascular Endothelial Growth Factor A
  • Bevacizumab