Aflibercept for Retinopathy of Prematurity: A Systematic Review and Meta-Analysis

Ophthalmic Surg Lasers Imaging Retina. 2021 Dec;52(12):673-681. doi: 10.3928/23258160-20211124-01. Epub 2021 Dec 1.

Abstract

Background and objective: To determine the effectiveness of aflibercept in retinopathy of prematurity (ROP).

Patients and methods: We performed a systematic review and meta-analysis of proportions from the literature in PubMed and Cochrane Library using search terms related to the use of aflibercept in ROP. Studies in non-preterm infants or that did not use aflibercept as the initial treatment were excluded. Risk of bias was assessed by the ROBINS-I (Risk Of Bias in Non-randomized Studies of Interventions) tool.

Results: We identified six case series. Collectively, 218 eyes were treated with aflibercept for ROP. We found an average 97% (95% confidence interval [CI], 93% to 99%) regression rate with aflibercept and an average 16% (95% CI, 5% to 41%) recurrence rate. With the exception of one outlier study, these numbers are similar to previous reports using anti-vascular endothelial growth factor (VEGF) agents in ROP.

Conclusions: Aflibercept holds promise for use in ROP and has been demonstrated to be efficacious in six case series. Randomized, controlled clinical trials appear warranted to compare aflibercept with other anti-VEGF agents. [Ophthalmic Surg Lasers Imaging. 2021;52:673-681.].

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Angiogenesis Inhibitors / therapeutic use
  • Humans
  • Infant
  • Infant, Newborn
  • Receptors, Vascular Endothelial Growth Factor / therapeutic use
  • Recombinant Fusion Proteins
  • Retinopathy of Prematurity* / drug therapy
  • Vascular Endothelial Growth Factor A

Substances

  • Angiogenesis Inhibitors
  • Recombinant Fusion Proteins
  • Vascular Endothelial Growth Factor A
  • aflibercept
  • Receptors, Vascular Endothelial Growth Factor