For children with Type I retinopathy of prematurity (ROP), laser treatments may seem like the preferable route compared with intraocular injections. After all, laser photocoagulation is noninvasive while anti-VEGF injections require a needle in the eye. But new research is showing that laser treatment can lead to unfavorable changes to several optical biometric components.

A Taiwanese team found that, in children with a history of ROP, those who underwent anti-VEGF injection developed better compared with those who underwent laser photocoagulation. They reviewed 48 eyes of 25 children (22 eyes were laser treated and 25 were given anti-VEGF injections). They measured the fovea microvasculature, retinal thickness, subfoveal choroid thickness, the fovea avascular zone (FAZ), the fovea, parafovea and perifoveal vessel density (VD). They also reviewed the patients’ refractive errors, spherical equivalent, astigmatism, cornea curvature, anterior chamber depth (ACD), lens thickness and axial length.

The children who received laser treatments had significantly smaller FAZs, higher fovea VD, lower parafoveal VD, thicker inner retinas, steeper cornea curvature, shallower ACD and thicker lens and a higher degree of myopia than the anti-VEGF group. No differences were seen in the axial length.

Chen Y, Chen S. Foveal microvasculature, refractive errors, optical biometry and their correlations in school-aged children with retinopathy of prematurity after intravitreal antivascular endothelial growth factors or laser photocoagulation. Br J Ophthalmol. August 16, 2019. [Epub ahead of print].