Retinopathy of Prematurity (ROP) is one of the most common causes of childhood blindness worldwide. Comparisons of anti-VEGF and laser treatments in ROP are relatively lacking, and the data are scattered and limited. The objective of this meta-analysis is to compare the efficacy of both treatments in type-1 and threshold ROP. A comprehensive literature search on ROP treatment was conducted using PubMed and Embase up to March 2017 in all languages. Major evaluation indexes were extracted from the included studies by two authors. The fixed-effects and random-effects models were used to measure the pooled estimates. The test of heterogeneity was performed using the Q statistic. Ten studies were included in this meta-analysis. Retreatment incidence was significantly increased for anti-VEGF (OR 2.52; 95% CI 1.37 to 4.66; P = 0.003) compared to the laser treatment, while the incidences of eye complications (OR 0.29; 95% CI 0.10 to 0.82; P = 0.02) and myopia were significantly decreased with anti-VEGF compared to the laser treatment. However, there was no difference in the recurrence incidence (OR 1.86; 95% CI 0.37 to 9.40; P = 0.45) and time between treatment and retreatment (WMD 7.54 weeks; 95% CI 2.00 to 17.08; P = 0.12). This meta-analysis indicates that laser treatment may be more efficacious than anti-VEGF treatment. However, the results of this meta-analysis also suggest that laser treatment may cause more eye complications and increase myopia. Large-scale prospective RCTs should be performed to assess the efficacy and safety of anti-VEGF versus laser treatment in the future.

The role of the IκB/NF‐κB signaling pathway in the uveoscleral outflow pathway was investigated with IκBα gene silencing mediated by the 3‐(dimethylamino)‐1‐propylamine‐conjugated glycogen (DMAPA‐Glyp) derivative. The IκBα‐siRNA‐loaded DMAPA‐Glyp complex was transfected into the ciliary muscles of rats by intracameral injection (labeled as the DMAPA‐Glyp+siRNA group). The Lipofectamine™ 2000 (Lipo)/siRNA complex and the naked siRNA were set as the controls. The mRNA and protein expression of IκBα, NF‐κBp65, and MMP‐2 were analyzed by real‐time PCR, western blotting, and in situ gelatin zymography. Nuclear translocation of NF‐κBp65 was analyzed by immunofluorescence. Rat intraocular pressure (IOP) was monitored pre‐ and postinjection. Gene transfection efficiency and toxicity of the DMAPA‐Glyp derivative were also evaluated. After RNA interference (RNAi), IκBα mRNA and protein expression were significantly inhibited. NF‐κBp65 mRNA and protein expression showed no significant differences. Nevertheless, nuclear translocation of NF‐κBp65 occurred in the DMAPA‐Glyp+siRNA group. Both mRNA expression and activity of MMP‐2 increased, with the largest increase in the DMAPA‐Glyp+siRNA group. IOP in the DMAPA‐Glyp+siRNA group fell to the lowest level on day 3 after RNAi. The levels of Cy3‐siRNA in the ciliary muscle of the DMAPA‐Glyp+siRNA group did not significantly decrease over time. At 7 and 14 d after RNAi, no significant pathological damage was detectable in the eyes injected with the DMAPA‐Glyp derivative or the DMAPA‐Glyp/siRNA complex. Taken together, our results suggest that downregulation of IκBα expression in the ciliary muscle plays a crucial role in reducing the IOP values of rats. IκBα may become a new molecular target for lowering IOP in glaucoma. The DMAPA‐Glyp derivative is safe and feasible as an effective siRNA vector in rat eyes.