Treatments for ROP
Laser Treatment: A laser is used to create small burns in the outer areas of the retina to slow or reverse abnormal blood vessel growth.1,2
Injected Medication: Medications called vascular endothelial growth factor (VEGF) inhibitors, also known as anti-VEGF agents, are injected into the eye.2 They interfere with the signals that promote abnormal blood vessel growth, stop the formation of abnormal blood vessels and prompt their regression.3-7 This may allow normal blood vessels to grow to the edge of the retina.7 Anti-VEGF medication aflibercept received US Food and Drug Administration (FDA) approval in early 2023, making it the first approved anti-VEGF therapy available for the treatment of premature infants with ROP.8 Additional anti-VEGF medications continue to be studied for treatment of ROP.9
Freezing Treatment (Cryotherapy): A cold instrument is used to freeze affected parts of the retina to stop abnormal blood vessel growth.10,11
Surgery (Vitrectomy, scleral buckle): A surgery may be needed to repair the retina if it peels away from the back of the eye (retinal detachment).12 A silicone support band, called a scleral buckle, may be used to maintain the retina in proper position.13
References
- Laser therapy for retinopathy of prematurity. Laser ROP Study Group. Arch Ophthalmol. 1994;112(2):154-156.
- National Eye Institute. Retinopathy of Prematurity. Last updated June 24, 2022. https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/retinopathy-prematurity
- Mintz-Hittner HA, Kennedy KA, Chuang AZ; BEAT-ROP Cooperative Group. Efficacy of intravitreal bevacizumab for stage 3+ retinopathy of prematurity. N Engl J Med. 2011; 364(7):603-615.
- Stahl A, Lepore D, Fielder A, et al. Ranibizumab versus laser therapy for the treatment of very low birthweight infants with retinopathy of prematurity (RAINBOW): an open-label randomized controlled trial. Lancet. 2019;394(10208):1551-1559.
- Mintz-Hittner HA. Intravitreal pegaptanib as adjunctive treatment for stage 3+ ROP shown to be effective in a prospective, randomized, controlled multicenter clinical trial. Eur J Ophthalmol. 2012 Sep-Oct;22(5):685-686.
- Sankar MJ, Sankar J, Chandra P. Anti-vascular endothelial growth factor (VEGF) drugs for treatment of retinopathy of prematurity. Cochrane Database Syst Rev. 2018;8(1):CD009734.
- Tran K, Cernichiaro-Espinosa LA, Berrocal A. Management of Retinopathy of Prematurity- Use of VEGF Therapy. Asia-Pacific Journal of Ophthalmology. 2018;7:56-62.
- Press Release. Aflibercept (Eylea®). February 8, 2023. https://investor.regeneron.com/news-releases/news-release-details/eylear-aflibercept-injection-approved-first-pharmacologic
- Roach L. Fighting ROP with anti-VEGF therapy. EyeNet. March 2019. https://www.aao.org/eyenet/article/fighting-rop-with-anti-vegf-therapy
- Multicenter trial of cryotherapy for retinopathy of prematurity. Preliminary results. Cryotherapy for Retinopathy of Prematurity Cooperative Group. Arch Ophthalmol. 1988;106(4):471-479.
- Palmer EA, Hardy RJ, Dobson V, et al; 15-year outcomes following threshold retinopathy of prematurity: Final results from the multicenter, trial of cryotherapy for retinopathy of prematurity. Arch Ophthalmol. 2005;123(3): 311-318.
- Repka MX, Tung B, Good WV, et al. Outcome of eyes developing retinal detachment during the Early Treatment for Retinopathy of Prematurity Study (ETROP). Arch Ophthalmol. 2006;124(1):24-30.
- Hansen ED, Hartnett ME. A review of treatment for retinopathy of prematurity. Expert Rev Ophthalm 2019;14(2):73-87.
- Ruan L, Shan HD, Liu XZ, Huang X. Refractive status of Chinese with laser-treated retinopathy of prematurity. Optom Vis Sci. 2015;92(4 suppl 1):S3-S9.
- Devgiri Memorial Superspecialty Eye Clinic. Intravitreal Anti VEGF Injection. https://devgirimemorialhospital.com/intravitreal-anti-vegf-injection/
- The Retina Institute. Cryopexy. https://www.tri-stl.com/vitrectomy-4
- Vitreous Retina Macula Consultants of New York. Scleral Buckle. https://www.vrmny.com/procedures/scleral-buckle/
All URLs accessed 7/6/22.
