Retinopathy of Prematurity

Abstract

The immature retinas of preterm newborns are susceptible to insults that disrupt neurovascular growth, which leads to retinopathy of prematurity. Suppression of growth factors due to hyperoxia and loss of the maternal-fetal interaction result in an arrest of retinal vascularisation (phase 1). Subsequently, the increasingly metabolically active, yet poorly vascularised, retina becomes hypoxic, stimulating growth factor-induced vasoproliferation (phase 2), which can cause retinal detachment. In very premature infants, controlled oxygen administration reduces but does not eliminate retinopathy of prematurity. Identification and control of factors that contribute to development of retinopathy of prematurity is essential to prevent progression to severe sightthreatening disease and to limit comorbidities with which the disease shares modifiable risk factors. Strategies to prevent retinopathy of prematurity will depend on optimisation of oxygen saturation, nutrition, and normalisation of concentrations of essential factors such as insulin-like growth factor 1 and ω-3 polyunsaturated fatty acids, as well as curbing of the effects of infection and inflammation to promote normal growth and limit suppression of neurovascular development.

Adenosine A2A receptor antagonism protects against hyperoxia‐induced retinal vascular loss via cellular proliferation

“…Retinopathy of prematurity (ROP) is a retinal vascular disorder with retarded postnatal vascular development and pathological angiogenesis in premature and very low‐birth weight infants 1‐4 . ROP is one of the major causes of blindness in children worldwide as it causes myopia, strabismus, amblyopia, and severe retinal detachment, resulting in blindness 3,4 .…”

“…Retinopathy of prematurity (ROP) is a retinal vascular disorder with retarded postnatal vascular development and pathological angiogenesis in premature and very lowbirth weight infants. [1][2][3][4] ROP is one of the major causes of blindness in children worldwide as it causes myopia, strabismus, amblyopia, and severe retinal detachment, resulting in blindness. 3,4 ROP is characterized by two distinct pathological processes: an early ischemic/hyperoxia stage when the undeveloped retinal vessels are damaged by high oxygen concentration, resulting in the cessation of vascular development and the formation of retinal avascular area, 5 a late hypoxic stage when the retina is subjected to the increase of hypoxia-inducible factor 1α (HIF-1α) signaling pathway and vascular endothelial growth factor (VEGF) level, which further leads to the formation of retinal neovascularization (RNV).…”

“…[1][2][3][4] ROP is one of the major causes of blindness in children worldwide as it causes myopia, strabismus, amblyopia, and severe retinal detachment, resulting in blindness. 3,4 ROP is characterized by two distinct pathological processes: an early ischemic/hyperoxia stage when the undeveloped retinal vessels are damaged by high oxygen concentration, resulting in the cessation of vascular development and the formation of retinal avascular area, 5 a late hypoxic stage when the retina is subjected to the increase of hypoxia-inducible factor 1α (HIF-1α) signaling pathway and vascular endothelial growth factor (VEGF) level, which further leads to the formation of retinal neovascularization (RNV). 6 With the increased popularity of ROP screening in preterm infants and improved diagnostic rate in some developing and developed countries, most ROP cases are early-stage.…”

Morphological and Otsu’s Thresholding-Based Retinal Blood Vessel Segmentation for Detection of Retinopathy

“…Retinal blood vessel segmentation also enable detection of haemorrhages, microaneurysms, irregularities in the route of blood vessels and neovascularization [1][2][3][4][5]. The accuracy of retinal blood vessel segmentation is important to ensure accurate extraction and measurement of features for detection/diagnosis of retinal related diseases, including stroke [6], hypertensive retinopathy (HR) [7], diabetic retinopathy [8], and retinopathy of prematurity [9]. Manual segmentation of the blood vessel is time consuming and prone to human error, thus not practical when number of images is large and the vessel structures are complicated [10,11].…”