Laser Treatment May Increase Myopia Severity in Children With Retinopathy of Prematurity

Girl visiting pediatric optometrist
Pediatric optometrist helping little girl to put on test glasses when checking her eyesight
Intravitreal bevacizumab injections did not affect myopic progression and decreased the amount of laser treatments needed to treat retinopathy of prematurity.

Treating children born with retinopathy of prematurity (ROP) with lasers may result in an increased trend toward severe myopia, according to a study published in the American Journal of Ophthalmology.

Findings also confirmed that intravitreal bevacizumab (IVB) injections did not impact myopic progression and decreased the amount of laser treatment needed to treat ROP

Researchers identified premature infants with ROP (N=88) who were treated with IVB (n=22, median age 24 weeks), lasers (n=48, median age 25 weeks), or a combination of both (n=18, median age 24.5 weeks) between 2011 and 2020. The team included a total of 2-13 refractions (median 3) over the course of 0.5–8.5 years (median 3.2 years) and compared the data between subgroups.   

The investigators determined that infants treated with lasers exhibited a more rapid progression toward myopia regardless of whether they were treated with IVB treatment (P <.001). They also noted that the number of laser spots predicted myopic progression by approximately 0.16 D per 100 laser spots (P =.0006). Patients treated with laser following IVB received fewer laser spots than those treated exclusively with lasers, and secondary laser treatment usually occurred at an older age.  

ROP stage and zone also significantly impacted myopic progression, with the increased severity of illness yielding a faster myopic progression (P <.0001 and P =.0215, respectively).

“The retina is a known mediator of eye growth and refractive development, and therefore its ablation may play a role in the process of myopization,” according to the researchers. “If so, then delaying laser may be protective against early refractive changes that can be seen in these children.”

The study is limited by its retrospective nature and small sample size. 


Wiecek E, Akula J, Vanderveen D, et al. Longitudinal change of refractive error in retinopathy of prematurity treated with intravitreal bevacizumab or laser photocoagulation. Am J Ophthalmol. Published online March 31, 2022. doi:10.1016/j.ajo.2022.03.020.