{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:38:13Z","timestamp":1792791493803,"version":"4.5.0"},"reference-count":104,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T00:00:00Z","timestamp":1778803200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Retinopathy of prematurity (ROP) survivors commonly develop myopia, yet refractive sequelae may differ substantially by treatment. We compared long term refractive outcomes after anti-VEGF, laser photocoagulation, cryotherapy, and vitrectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review was performed using PubMed, Embase, Web of Science, and the Cochrane Library from inception to July 2025. We also screened records from a curated EndNote library. The primary outcomes were mean spherical equivalent (SE) and the prevalence of high myopia (SE \u2264 \u22125.0 D). Pooled estimates were calculated using a DerSimonian and Laird random effects model. Prespecified subgroup analyses compared treatment zone (Zone I vs. Zone II or III) and monotherapy vs. combination therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eighty-six studies, including 10,269 eyes were analyzed. Anti-VEGF had the least myopic pooled mean SE (\u22121.9 D) compared with laser (\u22123.8 D), cryotherapy (\u22125.8 D), and vitrectomy (\u22126.3 D). High myopia prevalence was 21.3% after anti-VEGF versus 42.6% after laser, and 55.4% to 58.6% after vitrectomy or cryotherapy. Compared with laser, anti-VEGF reduced the risk of high myopia (RR = 0.39; 95% CI: 0.25\u20130.61). Heterogeneity was moderate to high (I\n                      <jats:sup>2<\/jats:sup>\n                      = 52%\u201378%), and Egger\u2019s tests were not significant (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.21 for SE;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.37 for high myopia).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Among major ROP treatments, anti-VEGF was associated with the most favorable refractive outcomes, while cryotherapy and vitrectomy showed the highest myopic burden. These findings support incorporating long term refractive consequences and zone-specific risk into treatment selection and follow up planning.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1813154","type":"journal-article","created":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T06:20:47Z","timestamp":1778826047000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Refractive outcomes following anti-VEGF, vitrectomy, cryotherapy, and laser photocoagulation for retinopathy of prematurity: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Yu-Te","family":"Huang","sequence":"first","affiliation":[{"name":"Graduate Institute of Biomedical Sciences, China Medical University","place":["Taichung, Taiwan"]},{"name":"Department of Ophthalmology, Eye Center, China Medical University Hospital","place":["Taichung, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I-Ming","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Medical Research, China Medical University","place":["Taichung, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I-Jong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, National Taiwan University Hospital","place":["Taipei, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Ching","family":"Shao","sequence":"additional","affiliation":[{"name":"Graduate Institute of Biomedical Sciences, China Medical University","place":["Taichung, Taiwan"]},{"name":"Department of Ophthalmology, Eye Center, China Medical University Hospital","place":["Taichung, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ning-Yi","family":"Hsia","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Eye Center, China Medical University Hospital","place":["Taichung, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui-Ju","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Eye Center, China Medical University Hospital","place":["Taichung, Taiwan"]},{"name":"School of Chinese Medicine, China Medical University","place":["Taichung, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1130","DOI":"10.1001\/archopht.1984.01040030908011","article-title":"An international classification of retinopathy of prematurity.","volume":"102","year":"1984","journal-title":"Arch Ophthalmol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1016\/j.survophthal.2022.11.007","article-title":"Retinopathy of prematurity: a review of pathophysiology and signaling pathways.","volume":"68","author":"Fevereiro-Martins","year":"2023","journal-title":"Surv Ophthalmol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"e2021053924","DOI":"10.1542\/peds.2021-053924","article-title":"Retinopathy of prematurity: a global perspective and recent developments.","volume":"150","author":"Sabri","year":"2022","journal-title":"Pediatrics."},{"key":"B4","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1001\/archopht.1988.01060130517027","article-title":"Multicenter trial of cryotherapy for retinopathy of prematurity. 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