Optic Nerve Alterations Following Intravitreal Injection and Laser in Infants With Retinopathy of Prematurity

Purpose: The purpose of this study was to compare the effects of intravitreal injection and laser treatment for retinopathy of prematurity (ROP) on the optic nerve in infants. Methods: This was a retrospective cohort study. The participants were 551 eyes of preterm infants from January 2022 to March 2025. The preterm infants enrolled in this study were divided into the ROP treatment group, the ROP group, and the healthy control group. The treatment group was further subdivided into the intravitreal injection group and the laser group. Results: The vertical cup-to-disc ratio of the optic nerve in retinal images was measured at 4-week intervals from 36 to 60 weeks postmenstrual age (PMA). From PMA 36 to 60 weeks, the cup-to-disc ratio demonstrated significantly greater growth in the ROP treatment group in comparison to the other two groups. Starting from 40 weeks PMA, a statistically significant elevation in the cup-to-disc ratio was observed in the intravitreal injection group compared with the laser group and the control group. Additionally, except for the 56- to 60-week PMA, the intravitreal injection group showed higher cup-to-disc ratio increases than the laser group. Conclusions: The present study found that treated ROP leads to a higher cup-to-disc ratio. Furthermore, intravitreal injections result in a greater increase in cup-to-disc ratio compared to laser treatment, with this effect persisting up to 60 weeks PMA.