Reported Retinal Detachment in Anti-VEGF-Treated Retinopathy of Prematurity: A Systematic Review and Meta-Analysis
6 affiliations
- 1Department of Ophthalmology, West China Second University Hospital, Sichuan University, Chengdu 610041, China
- 2Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610041, China
- 3Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
- 4Beijing Ophthalmology & Visual Science Key Lab, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
- 5Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu 610041, China
- 6Department of Ophthalmology, Xizang Hospital of West China Hospital, Sichuan University, Lhasa 857000, China
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.
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BibTeX
@article{liu2026reported,
title = {{Reported Retinal Detachment in Anti-VEGF-Treated Retinopathy of Prematurity: A Systematic Review and Meta-Analysis}},
author = {Guina Liu and Guojiao Song and Siqi Wang and Wei Xu and Hanqing Zhao and Yunhan Tao and Wenbin Wei and Xiaoshuang Jiang and Hongtao Liu},
journal = {Journal of clinical medicine},
year = {2026},
month = sep,
doi = {10.3390/jcm15197598},
url = {https://europepmc.org/article/PMC/PMC13666268},
note = {CC BY},
}
RIS
TY - JOUR
TI - Reported Retinal Detachment in Anti-VEGF-Treated Retinopathy of Prematurity: A Systematic Review and Meta-Analysis
AU - Guina Liu
AU - Guojiao Song
AU - Siqi Wang
AU - Wei Xu
AU - Hanqing Zhao
AU - Yunhan Tao
AU - Wenbin Wei
AU - Xiaoshuang Jiang
AU - Hongtao Liu
PY - 2026
DA - 2026/09/30
JO - Journal of clinical medicine
DO - 10.3390/jcm15197598
UR - https://europepmc.org/article/PMC/PMC13666268
AB - 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.
SN - 2077-0383
ER -