Management of Retinopathy of Prematurity in the Anti-VEGF Era: Consensus and Recommendations From the Taiwan Pediatric Retina (TPR) Group.
Journal
American journal of ophthalmology
Journal Volume
281
Start Page
502
End Page
515
ISSN
1879-1891
Date Issued
2026-01
Author(s)
Chen, Yen-Chih
Chi, Sheng-Chu
Ho, Margaret Ming-Chih
Hsia, Ning-Yi
Chen, San-Ni
Chen, Yi-Hao
Chou, Yu-Bai
Lai, Yu-Hung
Lin, Hui-Ju
Tsai, Hsiang-Ling
Wu, Wei-Chi
Abstract
Objective: Retinopathy of prematurity (ROP) is the leading cause of childhood blindness, particularly in preterm infants. In Taiwan, the absence of national guidelines and the variability in clinical practice have highlighted the need for locally adapted consensus recommendations.
Methods: An expert panel of eleven ophthalmologists from 8 tertiary centers in Taiwan convened to develop a consensus on ROP management. Through a structured process that included key question formulation, systematic literature review, iterative discussion, and voting, the panel established consensus statements. Agreement was defined as ≥75% of panelists voting "agree" or "strongly agree" using a 5-point Likert scale.
Results: Consensus recommendations were developed across 3 major domains: screening, treatment, and follow-up. For screening, the panel endorsed criteria commonly used in Taiwan-gestational age <32 weeks or birth weight <1500 g-but emphasized the need for population-based validation. Both antivascular endothelial growth factor (VEGF) agents and laser photocoagulation were recognized as acceptable first-line treatments for type 1 ROP, with individualized treatment decisions based on disease characteristics, anesthesia risk, and follow-up capacity. Guidelines were also established for the management of ROP reactivation, procedural protocols, and agent selection. For follow-up, the panel recommended extended surveillance after anti-VEGF therapy and outlined the criteria for identifying and monitoring persistent avascular retina. Follow-up schedules were proposed to detect long-term ocular and neurodevelopmental complications.
Conclusions: This consensus provides updated evidence-based guidance for ROP care in Taiwan, addressing both traditional and emerging clinical challenges. These recommendations aim to standardize care practices while remaining adaptable to future research and evolving clinical needs.
Type
journal article