Effect of Bevacizumab Compared with Laser Therapy on the Neurodevelopmental Results in Preterm Infants with Severe Retinopathy of Prematurity: a Meta-Analysis

We performed a meta-analysis to evaluate the effect of bevacizumab compared with laser therapy on the neurodevelopmental results in preterm infants with severe retinopathy of prematurity. A systematic literature search up to November 2021 vs as done and 13 studies included 946 preterm infants with severe retinopathy of prematurity at the start of the study; 350 of them were provided with bevacizumab, and 596 were laser therapy. They were reporting relationships about the effect of bevacizumab compared with laser therapy on the neurodevelopmental results in preterm infants with severe retinopathy of prematurity. We calculated the odds ratio (OR) or mean difference (MD) with 95% confidence intervals (CIs) to assess the effect of bevacizumab compared with laser therapy on the neurodevelopmental results in preterm infants with severe retinopathy of prematurity using the dichotomous or contentious method with a random or fixed-effect model. Bevacizumab had significantly higher cognitive impairment (OR, 1.50; 95% CI, 1.07-2.10, p = 0.02), lower motor composite scores (MD, -4.37; 95% CI, -6.91- -1.83, p < 0.001), and lower language cognitive composite scores (MD, -5.70; 95% CI, -7.96- -3.45, p< 0.001) compared to laser therapy in subjects with severe retinopathy of prematurity. However, bevacizumab had no significant difference in the cognitive composite scores (MD, -1.00; 95% CI, -2.58-0.58, p = 0.21) compared to laser therapy in subjects with severe retinopathy of prematurity. Bevacizumab had significantly higher cognitive impairment, lower motor composite scores, and lower language cognitive composite scores, and no significant difference in the cognitive composite scores compared to laser therapy in preterm infants with severe retinopathy of prematurity. Further studies are required to validate these findings or to affect the confidence level.