Comparison of Intravitreal Bevacizumab and Laser Photocoagulation in the Treatment of Retinopathy of Prematurity Ramak Roohipoor, MD, 1 Reza Karkhaneh, MD, 1 Mohammad Riazi-Esfahani, MD, 1,2 Afsar Dastjani Farahani, MD, 1 Alireza Khodabandeh, MD, 1 Nazanin Ebrahimi Adib, MD, 1 Marjan Imani, MD, 1 Hassan Khojasteh Jafari, MD, 1 Hamid Riazi-Esfahani, MD, 1 Jamaleddin Hosseinpour, MD, 1 Mohammad Zarei, MD, 1 Hamed Ghasemi, MD, 1 Masoud Mirghorbani, MD, MPH, 1 Mehdi Yaseri, PhD, 1 Samaneh Davoudi, MD, 3 Bobeck Mojtahedi, MD 4,5 Purpose: To compare the outcomes of patients with type I retinopathy of prematurity (ROP) treated with either intravitreal bevacizumab (IVB) or retinal laser photocoagulation (RLP). Design: Retrospective case series. Participants: Infants treated for type I ROP with IVB or RLP. Methods: Patients who were born between January 2011 and December 2014 and were treated in Farabi Eye Hospital were included. The outcomes were stratified and analyzed, based on the treatment type and ROP zone. Main Outcome Measures: Need for retreatment, time to regression, refractive errors, retinal adverse anatomic outcomes, and rate of complications. Results: Five hundred twenty-three patients were treated for type 1 ROP, of whom 493 (986 eyes) met in- clusion criteria. Seven hundred twenty-four eyes (73.4%) received IVB, and 262 eyes (26.5%) received RLP. Re- treatment (because of recurrent or persistent retinopathy) occurred in 14.4% (106/724) of eyes initially treated with IVB and in 8.8% (23/262) eyes initially treated with RLP (P ¼ 0.065). Re-treatment was not significantly different between the 2 groups for patients with zone I disease (P ¼ 0.978). Re-treatment rate was considerably higher in patients with zone II disease treated with IVB (69/558 [12.3%]) compared with those treated with RLP (20/251 [7.9%]; P ¼ 0.017). In the IVB group, 82.8% and 53.4% of eyes showed an avascular area in zone III (despite ROP regression) at 1 and 2 years after treatment, respectively. The spherical power and the spherical equivalent were significantly higher in eyes treated with RLP (1.312.83 diopters [D] and 2.842.77 D, respectively) than eyes treated with IVB (0.193.21 D and 1.263.19 D, respectively; P ¼ 0.016 and P ¼ 0.007, respectively). Differ- ences in astigmatic power were not significant. Conclusions: Both IVB and RLP are effective treatments for type 1 ROP. Longer follow-up time is necessary for infants treated with IVB. More patients with zone II disease treated with RLP achieved disease regression after a single treatment than those who received IVB, although outcomes after re-treatment were comparable except for a greater refractive error in patients treated with RLP. Ophthalmology Retina 2018;-:1e7 ª 2018 by the American Academy of Ophthalmology Supplemental material available at www.ophthalmologyretina.org. Retinopathy of prematurity (ROP) continues to be a leading cause of visual morbidity worldwide. 1 Although its incidence has declined in developed countries, increases in premature births, improvements in keeping premature children alive, and lack of ROP screening programs have resulted in high disease prevalence in the developing world. Although the pathogenesis of ROP is incompletely understood, the 2 main established risk factors are low gestational age and low birth weight. 2 Retinopathy of prematurity is a biphasic disorder consisting of an initial phase of oxygen-induced vascular obliteration followed by a period of hypoxia-induced vessel proliferation. Vascular endothelial growth factor (VEGF) dysregulation has been implicated as an important factor. 3 Peripheral retinal ablation with cryotherapy and, now more commonly, retinal laser photocoagulation (RLP) reduce proangiogenic factors by destroying ischemic tissue; how- ever, these treatments are associated with negative sequela including visual field loss and the risk of high myopia developing. 4,5 Moreover, RLP requires sedation or general anesthesia and requires a high level of expertise. As a result, less destructive and simpler methods to treat ROP long have been sought. 4,6,7 The off-label use of anti-VEGF, most commonly intravitreal bevacizumab (IVB), increasingly has 1 Ó 2018 by the American Academy of Ophthalmology Published by Elsevier Inc. https://doi.org/10.1016/j.oret.2018.01.017 ISSN 2468-6530/18