Retinopathy of prematurity: from oxygen management to molecular manipulation

Molecular and Cellular Pediatrics

Review

Susmito Biswas¹  Jonathan Woods² 

[1] Manchester Royal Eye Hospital, Manchester University Hospital NHS Foundation Trust, Oxford Rd, M13 9WL, Manchester, UK;University of Birmingham Medical School, Medical School, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, B15 2TT, Birmingham, UK;

关键词: Infant;    Newborn;    Retinopathy of prematurity;    Ophthalmoscopy;    Cell proliferation;    Oxygen;   

DOI  :  10.1186/s40348-023-00163-5

 received in 2022-11-24, accepted in 2023-08-11,  发布年份 2023

来源: Springer

【 摘 要 】

IntroductionRetinopathy of prematurity (ROP) is a vasoproliferative disorder of the premature retina with the potential to progress to extraretinal neovascularisation. This review serves as an introduction to retinopathy of prematurity (ROP), outlining key parts of ROP pathophysiology, diagnosis and treatment. ROP is traditionally diagnosed by indirect ophthalmoscopy and classified using anatomical zones, stages of disease, and the presence or absence of “plus disease” (dilation and tortuosity of the major retinal arterioles and venules). ROP has a bi-phasic pathophysiology: initial hyperoxia causes reduced retinal vascularisation, followed by pathological vaso-proliferation resulting from subsequent hypoxia and driven by vascular endothelial growth factor (VEGF).Advancements in managementThis review summarises previous trials to establish optimum oxygen exposure levels in newborns and more recently the development of anti-VEGF agents locally delivered to block pathological neovascularisation, which is technically easier to administer and less destructive than laser treatment.Future directionsThere remains an ongoing concern regarding the potential unwanted systemic effects of intravitreally administered anti-VEGF on the overall development of the premature baby. Ongoing dosing studies may lessen these fears by identifying the minimally effective dose required to block extraretinal neovascularisation.

【 授权许可】

CC BY   
© Springer Nature Switzerland AG 2023

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Fig. 4