Infant's eye with glowing retinal vessels, symbolizing anti-VEGF treatment impact on vision.

Shedding Light on Infant Eye Health: How Anti-VEGF Treatments are Minimizing Myopia Risk in Premature Babies

Mira Elwood in Health & Wellness December 2025 • 4 min read.

"Discover how a new approach is changing the landscape of refractive error correction for premature infants, potentially leading to better vision outcomes."

Advances in treating Retinopathy of Prematurity (ROP) are drastically improving anatomical and functional outcomes, offering new hope in preventing blindness from retinal detachment. Anti-VEGF agents, a recent addition to the ROP-treatment toolkit, are showing significant clinical benefits, including a reduction in the rates of high and very high myopia following treatment, compared to traditional peripheral ablation.

Historically, treatments like cryotherapy and laser ablation, while effective in addressing ROP, often led to the development of high and very high myopia. This was often attributed to the severity of ROP itself, rather than the treatments. Interestingly, milder forms of myopia, termed 'myopia of prematurity,' are also seen in premature children without ROP and those with spontaneously regressing ROP.

This review explores the key causative factors that contribute to refractive errors in children treated with anti-VEGF agents for ROP. By understanding these factors, we can better optimize treatment strategies and improve visual outcomes for these vulnerable infants.

Anti-VEGF Treatment: A New Era for ROP and Refractive Error

Infant's eye with glowing retinal vessels, symbolizing anti-VEGF treatment impact on vision.

A comprehensive review of available literature, focusing on the effects of anti-VEGF agents on refractive error within the context of ROP, was conducted using PubMed. The search included terms like 'retinopathy of prematurity,' 'ROP,' 'refraction,' 'myopia,' and specific anti-VEGF drugs such as 'bevacizumab,' 'ranibizumab,' and 'aflibercept.'

Eleven relevant articles were identified, encompassing a total of 466 eyes treated with anti-VEGF agents. These studies reported on a variety of factors, including: average spherical equivalent (SE) refractive error in diopters, prevalence of myopia, and prevalence of high myopia.

The average SE refractive error reported after anti-VEGF monotherapy ranged from +0.75 D to -3.57 D.
The average age at the time of refraction in these studies ranged from 11.4 months to 5 years.
Different anti-VEGF agents may yield different prevalence of high myopia, with intravitreal bevacizumab yielding high myopia in 8%-35% of eyes versus 0 following intravitreal ranibizumab treatment.

These findings suggest that while anti-VEGF monotherapy for ROP generally leads to lower levels of myopia, the specific agent used may influence refractive outcomes. This highlights the importance of ongoing research to refine treatment protocols.

The Future of ROP Treatment: Minimizing Myopia and Maximizing Vision

Intravitreal anti-VEGF agents represent a significant advancement in the treatment of ROP, offering the potential to minimize myopia and decrease the incidence of high myopia compared to traditional retinal laser ablation.

While these outcomes are promising, further research is needed to address key aspects of this therapy, including long-term refractive and visual outcomes, long-term safety, optimal dosage, and the best specific anti-VEGF agent for each patient.

By continuing to investigate and refine anti-VEGF treatment strategies, we can move closer to a future where premature infants with ROP have the best possible chance for a lifetime of clear vision.

About this Article -

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Everything You Need To Know

What is Retinopathy of Prematurity (ROP), and how are anti-VEGF treatments involved?

Retinopathy of Prematurity (ROP) is a disease that affects premature infants, potentially leading to blindness due to retinal detachment. The anti-VEGF treatments, like bevacizumab, ranibizumab, and aflibercept, are used as a treatment for ROP. These anti-VEGF agents are showing significant clinical benefits in treating the ROP, potentially minimizing myopia and decreasing the incidence of high myopia, which is a significant advancement in the treatment of ROP.

How do anti-VEGF treatments affect myopia in premature infants?

Anti-VEGF agents help reduce the rates of high and very high myopia following treatment for Retinopathy of Prematurity (ROP). These agents are a recent addition to the ROP-treatment toolkit. When compared to traditional methods like cryotherapy and laser ablation, anti-VEGF treatments lead to lower levels of myopia, making them important for better vision outcomes. Different anti-VEGF agents may yield different prevalence of high myopia, highlighting the need to refine treatment protocols and improve visual outcomes.

What is myopia, and why is it a concern for premature infants?

Myopia is a refractive error where distant objects appear blurry. In the context of premature infants, myopia can arise from Retinopathy of Prematurity (ROP) or from prematurity itself, even without ROP. Anti-VEGF treatments are showing promise in reducing the incidence of high myopia, a severe form of the condition. This is a significant improvement over traditional treatments like cryotherapy and laser ablation, which often led to higher rates of myopia.

What are the key differences between anti-VEGF treatments and traditional treatments for Retinopathy of Prematurity (ROP)?

The main difference lies in their impact on refractive errors. Traditional treatments for Retinopathy of Prematurity (ROP), such as cryotherapy and laser ablation, often resulted in high myopia. Anti-VEGF treatments, however, show a lower prevalence of myopia and high myopia. Anti-VEGF treatments represent a significant advancement in the treatment of ROP, offering the potential to minimize myopia and decrease the incidence of high myopia compared to traditional retinal laser ablation.

What types of studies were conducted on anti-VEGF treatments?

The studies reviewed used intravitreal injections of anti-VEGF agents, specifically bevacizumab, ranibizumab, and aflibercept, to treat Retinopathy of Prematurity (ROP) in premature infants. The studies analyzed average spherical equivalent (SE) refractive error in diopters, the prevalence of myopia, and the prevalence of high myopia. The findings suggest that the specific anti-VEGF agent used may influence the refractive outcomes, highlighting the importance of ongoing research to refine treatment protocols.