Comparison of intravitreal bevacizumab injection and laser photocoagulation for type 1 zone II retinopathy of prematurity

Purpose: to compare the efficacy of intravitreal bevacizumab (ivb) injection with conventional laser photocoagulation in eyes with type 1 zone ii retinopathy of prematurity (rop). methods: preterm infants with type 1 rop in zone ii (stage 2 or 3 rop with plus disease) were randomly assigned to intravitreal injection of 0.625 mg/0.025 ml bevacizumab (group 1) or laser photocoagulation (group 2). patients were followed weekly for 4 weeks and then biweekly till 90 weeks gestational age. also, spherical and cylindrical refractive errors were compared at 90 weeks postmenstrual age (pma). results: a total of 116 preterm infants (232 eyes) were treated and completed the follow-up period. ivb injection was done in 154 eyes (77 cases), and laser photocoagulation was done in 78 eyes (39 cases). rop regressed after single ivb injection in 149 eyes (96.8%) and in 5 eyes (3.2%) after the second injection. cataract developed in one eye (0.63%) after ivb injection. rop regressed in 94.7% of treated eyes (76 eyes) in the laser photocoagulation group; however, retinal fold and traction developed in 2 eyes. spherical and also cylindrical refractive errors had no significant difference. conclusions: both ivb injection and laser photocoagulation are effective methods for the treatment of type 1 zone ii rop. however, retreatment requirement may be higher in the ivb injection group. ivb re-injection is an effective option for re treatment in persistent cases.