Related Experiment Video
Updated: Mar 30, 2026
Monitoring Dynamic Growth of Retinal Vessels in Oxygen-Induced Retinopathy Mouse Model
Published on: April 2, 2021
Screening and Treatment in Retinopathy of Prematurity
Andreas Stahl1, Wolfgang Göpel
1Eye Center, University of Freiburg, Department of Neonatology, University Medical Center-UKSH International, Campus Lübeck.
Insights
Retinopathy of prematurity screening is crucial for at-risk infants. While laser therapy is established, anti-VEGF treatments offer potential advantages but require more safety and efficacy data.
Area of Science:
- Ophthalmology
- Neonatology
- Pediatrics
Background:
- Retinopathy of prematurity (ROP) affects thousands of infants annually in Germany, with 2-5% requiring treatment.
- Despite existing screening and treatment, visual impairment remains a concern for affected children.
Purpose of the Study:
- To review the pathogenesis, screening, and treatment of ROP.
- To compare laser therapy with newer anti-VEGF treatments, focusing on recent literature (2011-2015).
Main Methods:
- Selective literature review using PubMed.
- Focus on publications from 2011-2015 regarding anti-VEGF therapy for ROP.
- Comparison of anti-VEGF treatment with established laser therapy.
Main Results:
- Screening is mandatory for premature neonates with risk factors (low gestational age, low birth weight, oxygen exposure).
- Laser therapy is effective for ROP stages 1-3 but causes scarring and myopia in 17-40% of cases.
- Anti-VEGF treatment shows promise in reducing scarring and myopia, but long-term safety and optimal dosing data are limited.
Conclusions:
- Evidence for anti-VEGF therapy is less robust than for laser therapy.
- Anti-VEGF may mitigate laser therapy's side effects but carries potential systemic risks (e.g., to brain, lungs).
- Further research is needed on anti-VEGF dosing, drug selection, and long-term safety for ROP treatment.
Background:
More than 11 000 children are examined for possible retinopathy of prematurity in Germany each year, and 2-5% of them are treated for it. Even though screening and treatment programs are in place, the affected children can still suffer visual impairment.
Methods:
In this article, we summarize the pathogenesis, screening, and treatment of retinopathy of prematurity on the basis of a selective review of pertinent literature, retrieved by a PubMed search. The article centers on publications from 2011 to 2015 on the new option of treatment with VEGF inhibitors and discusses it in comparison to laser therapy.
Results:
All premature neonates with a low gestational age at birth, low birth weight, or prolonged exposure to supplemental oxygen must undergo screening by an ophthalmologist. Laser therapy is effective for stages 1-3 and for aggressive posterior retinopathy of prematurity. Its disadvantages are the induction of scarring and the development of severe myopia in 17-40% of the children so treated. Anti-VEGF treatment (VEGF = vascular endothelial growth factor) does not induce any visible scarring and seems to cause less myopia, but long-term data on safety, dosing, and the choice of anti-VEGF drug are still lacking.
Conclusion:
The available evidence for anti-VEGF treatment is on a much lower level than the evidence for laser therapy. Anti-VEGF may be a way to avoid the disadvantages of laser therapy (scarring and severe myopia). Unlike laser therapy, however, the intravitreal injection of VEGF inhibitors may suppress systemic VEGF levels and potentially harm the developing brain, lungs, or other organs. The currently open questions about anti-VEGF treatment concern its dosing, choice of drug, and long-term safety.
