Trends in the Initial Treatment for Retinopathy of Prematurity in the United States

Background and Objective: The aim of this study was to characterize trends in choice of initial therapy for retinopathy of prematurity (ROP) in the United States. Patients and Methods: This is a cross-sectional time-series analysis on infants diagnosed with ROP categorized by initial treatment modality (laser photocoagulation/cryotherapy or intravitreal injection). TriNetX was used for data collection, and Cochran-Armitage trend tests were used to evaluate changes in the proportion of treatment modalities and agent usage over time. Results: A total of 2,050 infants met inclusion criteria. The proportion of infants treated with laser/cryotherapy decreased from 100% to 62.7% ( P < .0001). Bevacizumab decreased from 100% of all intravitreal injections to 76.7% ( P < .0001). Aflibercept use increased from 0% to 18.8% ( P < .0001). White infants were more likely to be treated with intravitreal anti-VEGF than Black or Hispanic infants ( P = .0061). Conclusion: The rates of anti-VEGF for initial treatment have been rising over the years; however, laser photocoagulation remains the most common treatment for ROP in the United States.