Long-term Outcome of Anti-VEGF Treatment in Retinopathy of Prematurity: A 12-Year Follow-Up with Ultra-Widefield Imaging

Purpose: Although treatment with Anti-VEGF is progressively more common, cases of truly long-term follow-up of Retinopathy of Prematurity remain rare. Rarer still is wide-field photographic evidence of a long-term patient journey, with stable untreated peripheral avascular retina – we present such a case. Methods: Clinical data including acuity and refraction were collected during ophthalmological reviews. Images were captured using Optomap (Optos, United Kingdom). Results: We report a unique case of 12 years of follow-up with accompanying wide-field imaging, in a case of ROP treated with Ranibizumab. Respiratory disease precluded a safe general anaesthetic for laser treatment, and disease regressed following one dose of Ranibizumab. The peripheral avascular retina has appeared stable without treatment. The child's development has otherwise been unremarkable. The data underscore the utility of Optomap imaging in monitoring ROP's course. The non-invasive nature of UWF imaging has not only provided a comprehensive retinal perspective without the need for sedation but has proven indispensable in evaluating long-term treatment efficacy. Conclusion: This case exemplifies the potential for long-term stabilization of ROP after anti-VEGF therapy without additional interventions uniquely supported by 12 years of UWF monitoring. Stability has so far been maintained despite the presence of peripheral avascular retina - an outcome that carries significant implications for the management of similar future cases.