BACKGROUND Retinopathy of prematurity (ROP) is the most common cause of preventable blindness in preterm infants. First-line treatments include intravitreal bevacizumab (IVB) or laser photocoagulation (LPC). OBJECTIVES The aim of the study was to evaluate neurodevelopmental safety of IVB compared to LPC for ROP. METHODS MEDLINE, Embase, and Cochrane library were searched up to September 2022. Studies were included with at least 12-month follow-up of primary outcomes such as severe neurodevelopmental impairment (sNDI), cerebral palsy (CP), and hearing impairment (HI). Secondary outcomes were moderate-to-severe neurodevelopmental impairment (msNDI), Bayley Scores of Infant Development (BSID-III), and visual impairment. RESULTS 1,231 patients from 11 comparative studies were included. Quality of evidence was rated low for all outcomes. IVB was associated with a higher risk for sNDI (risk ratio [RR] = 1.25, 95% confidence interval [CI]: [1.01, 1.53], p = 0.04); and CP (RR = 1.40, CI: [1.08, 1.81], p = 0.01) compared to LPC. There was no significant difference between IVB and LPC for msNDI (RR = 1.15, CI: [0.98, 1.35], p = 0.08) and HI (RR = 1.43, CI: [0.86, 2.39], p = 0.17). BSID-III percentile scores were similar between IVB and LPC, with weighted mean differences of 1.51 [CI = -1.25, 4.27], 2.43 [CI = -1.36, 6.22], and 1.97 [CI = -1.06, 5.01] for cognitive, language, and motor domains, respectively (p > 0.05). CONCLUSION To our knowledge, this is the largest meta-analysis on neurodevelopmental outcomes and the first to rigorously examine IVB monotherapy in ROP treatment. Compared to LPC, there was a marginally increased risk for sNDI and CP with IVB but little or no difference in the risk of msNDI and HI. Further randomized studies are needed to strengthen these findings.

中文翻译：

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玻璃体内贝伐单抗治疗早产儿视网膜病变后神经发育结果的荟萃分析。

背景早产儿视网膜病变（ROP）是早产儿可预防失明的最常见原因。一线治疗包括玻璃体内贝伐单抗（IVB）或激光光凝（LPC）。目的 该研究的目的是评估 IVB 与 LPC 相比对于 ROP 的神经发育安全性。方法 检索截至 2022 年 9 月的 MEDLINE、Embase 和 Cochrane 图书馆。研究纳入了对主要结局进行至少 12 个月随访的研究，例如严重神经发育障碍 (sNDI)、脑瘫 (CP) 和听力障碍 (HI) ）。次要结局是中度至重度神经发育障碍（msNDI）、婴儿发育贝利评分（BSID-III）和视力障碍。结果 11 项比较研究中纳入了 1,231 名患者。所有结果的证据质量均较低。IVB 与较高的 sNDI 风险相关（风险比 [RR] = 1.25，95% 置信区间 [CI]：[1.01, 1.53]，p = 0.04）；与 LPC 相比，CP（RR = 1.40，CI：[1.08，1.81]，p = 0.01）。IVB 和 LPC 之间的 msNDI（RR = 1.15，CI：[0.98，1.35]，p = 0.08）和 HI（RR = 1.43，CI：[0.86，2.39]，p = 0.17）没有显着差异。IVB 和 LPC 之间的 BSID-III 百分位数得分相似，认知、认知和认知方面的加权平均差异分别为 1.51 [CI = -1.25, 4.27]、2.43 [CI = -1.36, 6.22] 和 1.97 [CI = -1.06, 5.01]。分别是语言和运动领域（p > 0.05）。结论 据我们所知，这是关于神经发育结果的最大的荟萃分析，也是首次严格检验 ROP 治疗中 IVB 单药疗法的分析。与 LPC 相比，IVB 的 sNDI 和 CP 风险略有增加，但 msNDI 和 HI 的风险几乎没有差异。需要进一步的随机研究来加强这些发现。