Assessment and management of retinopathy of prematurity in the era of anti-vascular endothelial growth factor (VEGF)

Tsai, Andrew; Chou, Hung‐Da; Ling, Xiao Chun; Al-Khaled, Tala; Valikodath, Nita; Cole, Emily; Yap, Vivien; Chiang, Michael F.; Chan, Robison Vernon Paul; Wu, Wei‐Chi

doi:10.1016/j.preteyeres.2021.101018

Cited by 58 publications

(33 citation statements)

References 284 publications

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“…VEGF is an important angiogenic factor that regulates normal retinal vasculature development during the embryonic stage. 1 , 22 VEGF leads to the growth of retinal blood vessels toward the peripheral avascular retina during eye development. 22 The long-term effect of anti-VEGF therapy on retinal vascularization in children with ROP was uncertain until now.…”

Section: Discussionmentioning

confidence: 99%

Persistent Vascular Anomalies in Retinopathy of Prematurity Children

Ling¹,

Kang²,

Huang³

et al. 2023

Ophthalmology Science

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Section: Discussionmentioning

confidence: 99%

Persistent Vascular Anomalies in Retinopathy of Prematurity Children

Ling¹,

Kang²,

Huang³

et al. 2023

Ophthalmology Science

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“…Liang et al [ 92 ] reported that high aqueous levels of VEGF were associated with ROP involving the posterior zone of the retina. As anti-VEGF monoclonal antibodies have become one of the most important treatments for ROP [ 93 ], the role of systemic VEGF in the pathogenesis of ROP needs to be explored further.…”

Section: Cytokines: Characteristics and Actionsmentioning

confidence: 99%

Systemic Cytokines in Retinopathy of Prematurity

Lien

et al. 2023

JPM

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Retinopathy of prematurity (ROP), a vasoproliferative vitreoretinal disorder, is the leading cause of childhood blindness worldwide. Although angiogenic pathways have been the main focus, cytokine-mediated inflammation is also involved in ROP etiology. Herein, we illustrate the characteristics and actions of all cytokines involved in ROP pathogenesis. The two-phase (vaso-obliteration followed by vasoproliferation) theory outlines the evaluation of cytokines in a time-dependent manner. Levels of cytokines may even differ between the blood and the vitreous. Data from animal models of oxygen-induced retinopathy are also valuable. Although conventional cryotherapy and laser photocoagulation are well established and anti-vascular endothelial growth factor agents are available, less destructive novel therapeutics that can precisely target the signaling pathways are required. Linking the cytokines involved in ROP to other maternal and neonatal diseases and conditions provides insights into the management of ROP. Suppressing disordered retinal angiogenesis via the modulation of hypoxia-inducible factor, supplementation of insulin-like growth factor (IGF)-1/IGF-binding protein 3 complex, erythropoietin, and its derivatives, polyunsaturated fatty acids, and inhibition of secretogranin III have attracted the attention of researchers. Recently, gut microbiota modulation, non-coding RNAs, and gene therapies have shown promise in regulating ROP. These emerging therapeutics can be used to treat preterm infants with ROP.

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“…Notably, the i-ROP DL system has been found to diagnose plus disease as good and even better than experts (92% vs. 82% accuracy); it has potential to predict progression to treatment requiring ROP; and can also be used to survey regression post treatment [28,29,30]. Specifically, the i-ROP system generates a vascular severity score (VSS) [1,2,3,4,5,6,7,8,9] for ROP [31•]. In addition, the CNN was found to be accurate in the diagnosis of ROP stages 1, 2, and 3 in fundus images from datasets in North America and Nepal [32].…”

Section: Telemedicine and Artificial Intelligence For Ropmentioning

confidence: 99%

“…Moreover, cryotherapy had been shown to be associated with poor structural and functional outcomes in the treatment of zone I disease [40]. Lastly, it is important to note that skip areas following laser can lead to reactivation of disease [7].…”

Section: Laser Photocoagulationmentioning

confidence: 99%

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Current Management of Retinopathy of Prematurity

Tsai

Acaba-Berrocal

Sobhy

et al. 2022

Curr Treat Options Peds

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Purpose of Review This review aims to provide an update on the recent major advances in the management of retinopathy of prematurity (ROP). Recent Findings There have been a number of major advances in our understanding and management of ROP over the last decade: (1) The advent of improved imaging techniques and technological infrastructure has led to the increased use of telemedicine and potential use of artificial intelligence to enhance access to care for children at risk of developing ROP; (2) the International Classification of Retinopathy of Prematurity (ICROP) 3rd edition has provided updates in classification of ROP and response of ROP to treatment; and (3) the treatment paradigm has shifted from laser therapy exclusively to now having the option of anti-vascular endothelial growth factor (VEGF) therapy. This has led to greater interest in trying to better understand the possible adverse events related to systemic and local VEGF suppression. Summary There is a greater understanding in the diagnosis and treatment of ROP and its response to treatment. The advent of anti-VEGF therapy has provided ROP providers with a treatment modality that may lead to improved visual outcomes without the need for peripheral retinal ablation. However, there remain questions regarding systemic and local adverse events. Laser photocoagulation continues to be an effective primary therapy and may also be needed after or in conjunction with anti-VEGF treatment.

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Assessment and management of retinopathy of prematurity in the era of anti-vascular endothelial growth factor (VEGF)

Cited by 58 publications

References 284 publications

Persistent Vascular Anomalies in Retinopathy of Prematurity Children

Persistent Vascular Anomalies in Retinopathy of Prematurity Children

Systemic Cytokines in Retinopathy of Prematurity

Current Management of Retinopathy of Prematurity

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