Assessing the appropriate intravitreal ranibizumab dose for retinopathy of prematurity: A systematic review

Background: Despite the use of laser therapy as the current treatment for retinopathy of prematurity (ROP), the administration of ranibizumab is recognized as a promising alternative treatment for ROP despite the current use of laser therapy. Therefore, this systematic review aimed to systematically analyze the effectiveness of different ranibizumab dosage. Methods: A literature search of PubMed, Cochrane, and ScienceDirect was conducted for studies including infants with ROP, using intravitreal injection of ranibizumab (IVR) as primary monotherapy, and reporting ROP regression and recurrence. All studies were required to be written in English-language and published in the last ten years. The selection process followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Results: A total of ten studies were reviewed, including three randomized controlled trials, five retrospectives, and two case series. Furthermore, 549 patients and 867 eyes in the treatment group were evaluated, examining various stages of ROP and different therapeutic methods. All studies reported ROP regression, ranging from 68.9 to 100, while 80 reported ROP recurrence following IVR. Conclusion: Intravitreal injections of ranibizumab were effective in improving ROP outcomes. Meanwhile, lower doses of IVR provided comparable therapeutic benefits to the higher dose, potentially with fewer side effects. © The Author(s) 2025