Rates, Timing, and Predictors of Retreatment Across Risk-Cohorts in Retinopathy of Prematurity: Intravitreal Bevacizumab Injection Versus Laser.

Francisco Altamirano; Melissa Yuan; Celine Chaaya; Sandra Hoyek; Ju Hyun Jeon; Reem Alahmadi; Iason S Mantagos; Carolyn Wu; Audina M Berrocal; Efren Gonzalez; Deborah K Vanderveen; Ryan Gise; Nimesh A Patel

doi:10.1016/j.ajo.2026.06.041

PubMed · 42364706

Rates, Timing, and Predictors of Retreatment Across Risk-Cohorts in Retinopathy of Prematurity: Intravitreal Bevacizumab Injection Versus Laser.

Francisco Altamirano·Melissa Yuan·Celine Chaaya·Sandra Hoyek·Ju Hyun Jeon·Reem Alahmadi·Iason S Mantagos·Carolyn Wu·Audina M Berrocal·Efren Gonzalez·Deborah K Vanderveen·Ryan Gise·Nimesh A Patel

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Abstract

OBJECTIVE: To characterize rates, timing, and predictors of retinopathy of prematurity (ROP) retreatment among infants treated with primary laser or intravitreal bevacizumab injection. DESIGN: Retrospective consecutive, comparative clinical study. PARTICIPANTS: Infants who underwent initial treatment for treatment-warranted ROP (TW-ROP) with either intravitreal bevacizumab or laser photocoagulation between 2017 and 2023. METHODS: Patients were stratified into two treatment groups: primary laser group vs primary bevacizumab group. MAIN OUTCOME MEASURES: Retreatment within the first 3 months (0-90 days) was assessed and classified as early (≤30 days) or late (31-90 days). RESULTS: Two hundred and thirty eight eyes of 122 infants were treated for ROP; of those, 181 (76.1%) eyes of 93 (76.2%) patients were included. There were 116 (64.1%) eyes in the bevacizumab group, and 65 (35.9%) eyes in the laser group. Thirty-three (18.2%) eyes-all micro- or nano-premature (<27 weeks GA and/or <800 grams)-required retreatment for TW-ROP. Sixteen (8.8%) required early retreatment at a median postmenstrual age (PMA) of 40.4 weeks (IQR, 38.44-43.3). There were differences in the proportion of early retreated infants (21.5% for laser vs 1.7% for injection, P < .001). Seventeen (9.4%) eyes required late retreatment. The median PMA at late retreatment was 45.6 weeks (IQR, 43.7-47.4). Infants in the bevacizumab group had lower odds of retreatment within three months than those with laser (OR, 0.23; 95% CI, 0.06-0.82). Similarly, patients in the bevacizumab group had lower odds of requiring early retreatment compared to those with laser (OR, 0.08; 95% CI, 0.04-0.18). Within eyes with retreatment, infants in the bevacizumab group had a later PMA at retreatment than those in the laser group (B = 6.81; 95% CI: 4.68-8.93). AROP was associated with earlier PMA at retreatment (B = -7.72; 95% CI, -9.36 to -6.10). CONCLUSION: In this study, early retreatment was low (8.8%), with most eyes initially treated with laser (21.5%) rather than bevacizumab (1.7%). Aggressive ROP was associated with earlier retreatment, highlighting its role as a marker of more severe disease. Compared to laser, bevacizumab was associated with lower overall and early retreatment, and delayed need for additional intervention when necessary. All retreatments occurred in micro- or nano-premature infants, suggesting that medium-to-low risk infants may require less strict post-treatment monitoring.

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Humans Bevacizumab Retinopathy of Prematurity Intravitreal Injections Retrospective Studies Laser Coagulation Angiogenesis Inhibitors Female Male Infant, Newborn Retreatment Gestational Age Vascular Endothelial Growth Factor A Infant Risk Factors Time Factors Follow-Up Studies Journal Article Comparative Study

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Francisco Altamirano, Melissa Yuan, Celine Chaaya, Sandra Hoyek, Ju Hyun Jeon, Reem Alahmadi, Iason S Mantagos, Carolyn Wu, Audina M Berrocal, Efren Gonzalez, Deborah K Vanderveen, Ryan Gise, Nimesh A Patel. 2026-06-27. Rates, Timing, and Predictors of Retreatment Across Risk-Cohorts in Retinopathy of Prematurity: Intravitreal Bevacizumab Injection Versus Laser.. https://doi.org/10.1016/j.ajo.2026.06.041

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Journal Article; Comparative Study resource Comparative Study subject Female subject Follow-Up Studies subject Humans subject Infant subject Infant, Newborn subject Journal Article subject Male subject angiogenesis inhibitors subject

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