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Retinopathy of Prematurity (ROP): Are We There Yet?
Eva Coughlin1, Waylon Alvarado1, Veluchamy A Barathi2
1Ocular Immunology and Angiogenesis Lab, Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
Insights
Retinopathy of Prematurity (ROP) is a growing cause of preventable blindness in preterm infants globally. Standardizing care and improving access are crucial, but long-term safety of new treatments like anti-VEGF needs more research.
Area of Science:
- Ophthalmology
- Neonatology
- Public Health
Background:
- Retinopathy of Prematurity (ROP) affects preterm infants globally, linked to neonatal supplemental oxygen.
- Despite advances, ROP remains a leading cause of preventable childhood blindness.
- Rising preterm birth survival rates correlate with increasing ROP incidence worldwide.
Purpose of the Study:
- To highlight the need for global standardization in ROP screening, diagnosis, and management.
- To discuss the evolving treatment landscape, including intravitreal anti-VEGF injections.
- To emphasize the importance of multidisciplinary teamwork, parental involvement, and addressing socioeconomic disparities in ROP care.
Main Methods:
- This perspective synthesizes current knowledge and identifies gaps in ROP care.
- It reviews advancements in screening criteria (ICROP) and therapeutic interventions.
- It discusses challenges including access to care and the need for longitudinal safety data.
Main Results:
- ROP incidence is increasing globally, even in developed nations.
- Intravitreal anti-VEGF agents are transforming ROP management but require long-term safety evaluation.
- Global standardization of care, equitable access, and parental support are critical for improving outcomes.
Conclusions:
- Global standardization of ROP prevention and care is essential but currently incomplete.
- Equitable access to ROP-trained specialists remains a significant challenge.
- Further longitudinal research is necessary to clarify the long-term safety and efficacy of anti-VEGF treatments for ROP.
Abstract:
Retinopathy of Prematurity (ROP) affects preterm infants worldwide, involving abnormal development of retinal blood vessels associated with supplemental oxygen use in neonatal care. Although there have been strides in identifying at-risk infants, implementing early screening, updating disease criteria through the International Classification of Retinopathy of Prematurity (ICROP), and developing new therapies, ROP remains a leading cause of preventable blindness. As preterm birth survival rates rise, the incidence of ROP continues to increase and is projected to rise even in countries with abundant resources and well-established care programs. Improving ROP care requires global standardization of screening, diagnosis, and management to prevent missed diagnoses and minimize outcome variability. Intravitreal anti-vascular endothelial growth factor (VEGF) injections are changing the landscape of ROP management, but longitudinal research is needed to determine their long-term safety in preterm infants. Effective ROP management relies on teamwork across disciplines and open communication with parents. Given that parents are lifelong caregivers of a child who may be affected by ROP-related vision impairment, including them in the care team and encouraging psychosocial support is vital. Socioeconomic disparities and limited access to ROP-trained ophthalmologists exacerbate disease burden, underscoring the need for innovative solutions to improve access to care. This perspective emphasizes the importance of globally standardizing ROP prevention and care, noting that efforts are still incomplete, equitable access has not been realized, and the long-term role of anti-VEGF agents in ROP treatment remains unclear.
