ROP Treatment: Laser Therapy and Anti-VEGF Injections

Retinopathy of prematurity (ROP) is an eye disease that affects premature babies. It happens when blood vessels in the retina, the back part of the eye responsible for vision, grow abnormally. If left untreated, ROP can lead to vision loss or blindness.

Fortunately, there are effective treatments available for ROP. The primary treatment options for ROP are: laser therapy and anti-VEGF injections.

Laser Therapy

Laser therapy, also known as laser photocoagulation, is a well-established treatment for ROP. This procedure involves using a laser to destroy the abnormal blood vessels in the peripheral avascular retina, preventing them from growing and causing further damage. Laser therapy is highly effective in stopping the progression of ROP in most cases. The standard of care for ROP is currently laser ablation for severe cases.

While laser therapy has proven successful, it does have some drawbacks. The procedure destroys approximately two-thirds of the retina, and some patients may still progress to retinal detachment despite treatment.

The procedure can be done in the operating room or in the neonatal intensive care unit.

Anti-VEGF Injections

Anti-VEGF (anti-vascular endothelial growth factor) injections are a newer treatment option for ROP. VEGF is a protein that promotes the growth of new blood vessels. In ROP, VEGF levels are elevated, contributing to the abnormal blood vessel growth.

Anti-VEGF medications, such as bevacizumab, work by blocking the effects of VEGF, thus inhibiting the growth of abnormal blood vessels. Anti-VEGF injections have shown promising results in treating ROP, particularly in cases of zone I, stage 3 ROP with plus disease.

The BEAT-ROP study (Bevacizumab Eliminates the Angiogenic Threat of Retinopathy of Prematurity) demonstrated that intravitreal bevacizumab monotherapy was significantly more effective in preventing ROP recurrence than conventional laser therapy in infants with stage 3+ ROP.

In the BEAT-ROP study, infants were randomly assigned to receive either intravitreal bevacizumab or conventional laser therapy. The rate of ROP recurrence was significantly lower in the bevacizumab group (6%) compared to the laser therapy group (26%).

Benefits of anti-VEGF injections over laser therapy may include:

• Less destructive to the retin
• Easier procedure with reduced operating time
• No need for specialized equipment

However, long-term studies are still needed to fully evaluate the safety and efficacy of anti-VEGF injections in treating ROP. Potential complications of bevacizumab injections include vitreous or pre-retinal hemorrhage and transient vascular sheathing.

The Role of Early Detection

Early detection of ROP eye treatment is the key to preventing vision loss. Routine eye exams are critical for premature infants, even those born before 32 weeks gestation or weighing less than 1,500 grams. This allows the timely application of treating retinopathy of prematurity.

Choosing the Right Treatment

The best treatment option for ROP depends on several factors, including the stage and severity of the disease, the infant’s overall health, and the ophthalmologist’s expertise. A comprehensive eye examination by a qualified ophthalmologist is crucial to determine the most appropriate treatment approach for each individual infant whether that involves laser surgery for ROP, anti-VEGF for retinal diseases, or a combination of both.

ROP is a severe disease that, if unnoticed or untreated, can lead to severe vision loss in a child. However, if detected on time and provided with appropriate ROP management options, most cases of ROP can be managed successfully.

Regular follow-ups with an eye doctor are essential. Madurai Eye Center ensures timely interventions for babies suffering from ROP, including ROP laser therapy and anti-VEGF injections for ROP, giving them an optimistic outlook towards healthy vision.