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Updated: Jul 19, 2026
Oxygen-Induced Retinopathy Model for Ischemic Retinal Diseases in Rodents
Published on: September 16, 2020
Retinopathy of prematurity: from oxygen management to molecular manipulation
Jonathan Woods1, Susmito Biswas2
1University of Birmingham Medical School, Medical School, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. JAW911@student.bham.ac.uk.
Insights
Retinopathy of prematurity (ROP) is a retinal disorder in premature infants. Newer anti-VEGF treatments offer an alternative to laser therapy, but systemic effects require further study.
Area of Science:
- Ophthalmology
- Neonatology
- Vascular Biology
Background:
- Retinopathy of prematurity (ROP) is a vasoproliferative disorder of the premature retina.
- ROP pathophysiology involves initial hyperoxia, reduced vascularization, followed by hypoxia-driven vaso-proliferation.
- Diagnosis traditionally involves indirect ophthalmoscopy, classifying zones, stages, and "plus disease."
Purpose of the Study:
- To provide an introductory overview of retinopathy of prematurity (ROP).
- To outline key aspects of ROP pathophysiology, diagnosis, and treatment.
- To review advancements in ROP management, including anti-VEGF agents.
Main Methods:
- Review of previous trials on optimal oxygen exposure.
- Summary of the development and application of anti-VEGF agents.
- Discussion of diagnostic criteria including indirect ophthalmoscopy and "plus disease."
Main Results:
- Anti-VEGF agents offer a less destructive alternative to laser treatment for ROP.
- Local delivery of anti-VEGF agents is technically easier to administer.
- Established diagnostic methods for ROP include indirect ophthalmoscopy and classification systems.
Conclusions:
- Ongoing research focuses on minimizing systemic effects of intravitreal anti-VEGF therapy in premature infants.
- Dosing studies aim to identify the minimally effective dose of anti-VEGF agents.
- Concerns remain regarding potential systemic effects of anti-VEGF on infant development.
Introduction:
Retinopathy 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 Management:
This 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 Directions:
There 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.
