Intravitreal Injection and Prophylactic Laser Treatment in Pediatric Vitreoretinal Pathologies

Vascular endothelial growth factor (VEGF) is an important mediator of pathological neovascularization and vascular permeability of the eye. The increasing use of intravitreal therapies targeting VEGF has revolutionized the treatment of pediatric vitreoretinal diseases. Laser photocoagulation is the standard treatment method for retinopathy of prematurity. The aim is to ablate the avascular peripheral retina, but ablation of the peripheral retina with traditional laser therapy is destructive, causes complications, and does not prevent all vision loss, especially in cases of retinopathy of prematurity affecting zone 1 of the eye. In Coats disease, retinal telangiectasias are treated early with laser photocoagulation, but with ischemia, high levels of VEGF in the ocular fluid may contribute to increased permeability of telangiectatic blood vessels, leading to lipoprotein leakage and subsequent exudative retinal detachment. Therefore, anti-VEGF has been recommended as adjuvant therapy in the treatment of Coats disease. In this review, intravitreal injection and prophylactic laser treatment applications in Retinopathy of Prematurity and Coats Disease are mentioned.