Outcomes of Nonconfluent Diode Laser Panretinal Photocoagulation for Aggressive Posterior Retinopathy of Prematurity After Intravitreal Bevacizumab.

Purpose To assess the safety and efficacy of less dense pan-retinal photocoagulation (PRP) after intravitreal bevacizumab in aggressive posterior retinopathy of prematurity (APROP) infants. Methods Retrospective consecutive case series of premature infants diagnosed with APROP between August 2012 and November 2015 who received intravitreal bevacizumab with subsequent modified indirect diode laser PRP for reactivation or incomplete vascularization. Main outcome measures included post-procedural reactivation, retinal detachments, or anterior segment ischemia. Results 61 eyes of 31 premature infants were identified. The average gestational age was 24 +/- 2.2 weeks (range 22-27) and average birth weight was 661.5 +/- 167.1 g (range 340.0 - 930.5 g). Average follow-up was 3.9 +/- 1.3 years (range, 1.3 - 5.4 yrs). At last follow-up, no patient had experienced post-laser reactivation, retinal detachments (RD), anterior segment ischemia, or other laser complications. Conclusions This study suggests that nonconfluent PRP for APROP infants who have received intravitreal bevacizumab may be safe and effective. This study's strengths include a sizeable sample size, long-term follow-up of nearly 4 years, and consistency in treatment among patients by a single, experienced ROP specialist.