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Current update on retinopathy of prematurity: screening and treatment
Jing Chen1, Andreas Stahl, Ann Hellstrom
1Department of Ophthalmology, Harvard Medical School, Children's Hospital Boston, Boston, Massachusetts 02115, USA.
Insights
Retinopathy of prematurity (ROP) is a growing cause of infant blindness. Recent advances include genetic links, screening by weight gain, and anti-VEGF treatments, alongside early laser therapy improving visual outcomes.
Area of Science:
- Ophthalmology
- Neonatology
- Genetics
Background:
- Retinopathy of prematurity (ROP) is a leading cause of blindness in premature infants.
- Increasing survival rates of extremely preterm infants are associated with a rising incidence of ROP.
- Current treatments for ROP have limitations, necessitating novel approaches.
Purpose of the Study:
- To review recent literature on retinopathy of prematurity (ROP).
- To focus on advancements in ROP treatment options.
- To highlight newly developed methods for ROP screening and diagnosis.
Main Methods:
- Literature review of recent studies on ROP.
- Analysis of genetic findings related to ROP.
- Evaluation of new diagnostic and therapeutic strategies.
Main Results:
- Genetic predisposition to ROP identified, linking Wnt pathway genes to severe disease.
- A novel screening method predicts ROP risk based solely on postnatal body weight gain.
- Emerging anti-vascular endothelial growth factor (anti-VEGF) therapies show promise but require further clinical evaluation.
- Early laser treatment for Type 1 high-risk prethreshold ROP improves visual acuity outcomes at age six.
Conclusions:
- Timely screening and treatment are crucial for preserving visual function in premature infants at risk for ROP.
- Continued research into genetic factors and novel therapies like anti-VEGF is essential.
- Early intervention strategies, such as laser therapy, demonstrate improved long-term visual outcomes.
Purpose Of Review:
Despite current treatments, retinopathy of prematurity (ROP) remains a major cause of blindness in premature infants and the incidence is increasing with increased survival of infants born at very early gestational ages. This review summarizes the recent literature on ROP with a special focus on recent advances in treatment options as well as newly developed methods for disease screening.
Recent Findings:
Genetic studies find a genetic predisposition to ROP-linking genes in the Wnt pathway with development of severe ROP. With regard to diagnosis, a new screening method has been developed that allows prediction of ROP risk based on postnatal body weight gain alone. Formerly weight gain postnatally in combination with insulin-like growth factor levels was found to predict treatable ROP. New treatment options for severe cases of ROP have been proposed targeting vascular endothelial growth factor (VEGF). Whether anti-VEGF treatment is well tolerated in preterm infants, however, has to be further evaluated in controlled clinical trials. Finally, new reports from the early treatment ROP group suggest that early laser treatment for type 1 but not type 2 high-risk prethreshold ROP improves visual acuity outcomes at 6 years of age.
Summary:
With the increasing survival of premature infants and increased incidence of ROP, it is important to screen for ROP risk and treat at-risk patients in a timely manner to preserve their visual function and reduce complications.
