Clinical Outcomes of Anti-VEGF Monotherapy versus Combined Anti-VEGF and Laser Therapy in Retinopathy of Prematurity: A Systematic Review

This systematic review aims to compare the clinical outcomes of anti-vascular endothelial growth factor (anti-VEGF) monotherapy with combined anti-VEGF and laser therapy in infants with retinopathy of prematurity (ROP). ROP remains an important cause of preventable childhood visual impairment and blindness, particularly among preterm and low-birth-weight infants. Although anti-VEGF agents have increasingly been used for the treatment of ROP, uncertainty remains regarding whether anti-VEGF monotherapy or its combination with laser photocoagulation provides better clinical outcomes. This review will systematically identify, evaluate, and synthesize available evidence comparing these therapeutic approaches. Outcomes of interest will include treatment success, disease regression, recurrence or reactivation, retreatment, structural and visual outcomes, refractive outcomes, treatment-related complications, and other clinically relevant outcomes reported in eligible studies. The review will follow established systematic review methodology, including a predefined search strategy, eligibility criteria, study selection process, data extraction, risk-of-bias assessment, and quantitative or qualitative synthesis as appropriate. The findings are expected to provide an updated synthesis of evidence regarding the comparative effectiveness and safety of anti-VEGF monotherapy versus combined anti-VEGF and laser therapy and may help inform clinical decision-making and future research in the management of retinopathy of prematurity.