Safety and Efficacy of Combination Therapy with Anti-Vascular Endothelial Growth Factor and Laser for Retinopathy of Prematurity: A Systematic Review and Meta-Analysis.

Abstract

Aim: This systematic review and meta-analysis aimed to evaluate the safety and efficacy of combined laser and anti-VEGF therapy for (retinopathy of prematurity ROP), focusing on both structural and functional outcomes.

Methods: A comprehensive search was conducted in multiple databases to identify randomized controlled trials (RCTs) that investigated combination therapy for ROP. The PRISMA guidelines were followed. Data were extracted and analyzed using risk ratios and 95% confidence intervals (CIs). The Cochrane Risk of Bias tool was used to assess the risk of bias.

Results: Three RCTs involving a total of 162 premature infants were included in the meta-analysis. Combination therapy of anti-VEGF and laser photocoagulation was compared with other interventions. The pooled analysis of favorable structural outcomes did not show a statistically significant difference between combination therapy with anti-VEGFs and laser therapy compared to the interventions in the control groups (P=0.25). The incidence of adverse events was comparable between the combination therapy group and other intervention groups.

Conclusion: This systematic review and meta-analysis suggest that risk ratio of combination therapy with anti-VEGF and laser for ROP is associated with favorable outcomes, albeit insignificant. The safety profile of combination therapy appears to be similar to other interventions. However, due to the limited number of included studies, further research is needed.