Background: This report describes the use of combined laser photocoagulation and intravitreal bevacizumab administration for aggressive zone I retinopathy of prematurity (ROP).

Methods: A male patient, born at 25 weeks gestation with a birth weight of 884 g, received indirect laser photocoagulation and a 0.75 mg intravitreal bevacizumab injection to each eye for aggressive stage 3 zone I ROP. Structural outcomes were evaluated 3 months after treatment.

Results: At 3-month follow-up, treatment had resulted in ROP regression, prompt resolution of plus signs and neovascular proliferation in both eyes, and no signs of systemic or ocular adverse events.

Conclusions: The combination of indirect laser photocoagulation and intravitreal bevacizumab injection was well tolerated and induced prompt regression of aggressive zone I ROP.