Neonatal retinal hemorrhage and retinopathy of prematurity: a critical review of current practices and future directions

Linjiang Chen ¹, Yuhan Feng ¹, Zhibin Xu ²

⁰Department of Ophthalmology, Nanfang Hospital, Southern Medical University, Guangzhou, China.

Therapeutic Advances in Ophthalmology +

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November 19, 2025

View abstract on PubMed

Summary

Neonatal retinal hemorrhage and retinopathy of prematurity impact preterm infant vision. Early detection via advanced imaging and AI, alongside standardized criteria, is crucial for effective management and improved visual outcomes.

Area Of Science

Ophthalmology
Neonatology
Medical Imaging

Background

Neonatal retinal hemorrhage (RH) and retinopathy of prematurity (ROP) are leading causes of visual impairment in preterm infants.
Current diagnostic methods like indirect ophthalmoscopy have limitations in standardization and subjective variability.
Prematurity-related factors and neonatal complications increase the risk of RH and ROP.

Purpose Of The Study

To review current diagnostic and therapeutic strategies for RH and ROP.
To highlight the limitations of existing methods and the need for standardized criteria.
To explore emerging technologies and future directions for improved management.

Main Methods

Literature review synthesizing current approaches to RH and ROP management.
Analysis of diagnostic modalities including indirect ophthalmoscopy and digital retinal imaging.
Examination of risk factors, correlations between RH and ROP, and emerging technologies.

Main Results

Indirect ophthalmoscopy lacks standardization; digital imaging offers better visualization but has cost and training barriers.
Severe RH correlates with ROP progression, and factors like prematurity and neonatal complications increase risk.
Advances in digital imaging and AI show promise for early detection and timely interventions like anti-VEGF therapy.

Conclusions

Standardized diagnostic criteria are essential for optimal RH and ROP management.
Emerging technologies like AI and optical coherence tomography, along with novel treatments, offer future potential.
Enhanced screening, research collaboration, and public awareness are vital for improving long-term visual prognosis.

Keywords:

artificial intelligence digital retinal imaging early intervention neonatal retinal hemorrhage retinopathy of prematurity