Reported Retinal Detachment in Anti-VEGF-Treated Retinopathy of Prematurity: A Systematic Review and Meta-Analysis
In brief
Retinal detachment followed anti-VEGF treatment in 1.4% of ROP eyes
A review of 27 studies found retinal detachment in about 1 in 70 eyes treated with anti-VEGF drugs for retinopathy of prematurity. The risk was higher in studies of more severe disease, including Zone I and aggressive ROP, supporting prolonged follow-up for these infants. Most evidence was retrospective, and differences between studies limit precise risk estimates.
- Journal
- Journal of clinical medicine (Q1)
- Published
- 30 September 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Guina Liu, Guojiao Song, Siqi Wang, Wei Xu, Hanqing Zhao, Yunhan Tao, et al.
- PMID
- 42882060
- DOI
- 10.3390/jcm15197598
Why clinicians should know about it
- Picked for Ophthalmology (top studies of the week, 18 October 2026): Retinal detachment incidence after anti‑VEGF ROP treatment
Abstract
Objectives: To estimate the incidence of reported retinal detachment (RD) after primary anti-vascular endothelial growth factor (anti-VEGF) treatment for retinopathy of prematurity (ROP) and to explore study-level factors associated with RD incidence. Methods: PubMed, EMBASE, Cochrane Library, and Web of Science were searched up to 24 May 2026, for English-language studies reporting RD outcomes after anti-VEGF monotherapy for ROP. Pooled incidence was estimated with a random-effects model using Freeman-Tukey double arcsine transformation. Heterogeneity, subgroup differences, publication bias, and leave-one-out sensitivity were assessed. Results: Twenty-seven studies (5598 eyes; 135 RD events) were included, comprising twelve case series, thirteen cohort studies, and two randomized controlled trials; thus, the evidence was predominantly retrospective. The pooled RD incidence was 1.4% (95% CI, 0.5-2.7%; I2 = 80.8%). The estimate remained stable on leave-one-out sensitivity analysis; the exclusion of Tong et al. markedly reduced heterogeneity. Higher RD incidence was observed in Asian studies, single-center studies, and studies with predominantly Zone I ROP or aggressive ROP (AROP). Incidence varied by postmenstrual age at treatment, gestational age, birth weight, and anti-VEGF agent. No significant publication bias was detected. Conclusions: RD after primary anti-VEGF therapy for ROP is uncommon but sight-threatening, with higher incidence associated with greater disease severity and postmenstrual age. Prolonged, risk-stratified follow-up is warranted for infants with Zone I or AROP. Standardized RD definitions, subtype classification, and severity-adjusted prospective comparisons are needed.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.