Retinopathy of prematurity: a review of epidemiology and current treatment strategies

Abstract

Retinopathy of prematurity (ROP) is among the most common causes of childhood blindness. Three phases of ROP epidemics have been observed worldwide since ROP was first described in the 1940s.Despite advances in neonatal care, the occurrence of ROP and associated visual impairment has been increasing somewhere on Earth and remains difficult to control. Conventional treatment options for preventing ROP progression include retinal ablation using cryotherapy or laser therapy. With the emergence of anti-vascular endothelial growth factor (anti-VEGF) treatment for ocular diseases, the efficacy and safety of anti-VEGF therapy for ROP have recently been actively discussed. In the advanced stage of ROP with retinal detachment, surgical treatment including scleral buckling or vitrectomy is needed to maintain or induce retinal attachment. At this stage, the visual outcome is usually poor despite successful anatomical retinal attachment. Therefore, preventing ROP progression by timely screening examinations and treatment remains the most important part of ROP management.

New Aspects on the Treatment of Retinopathy of Prematurity: Currently Available Therapies and Emerging Novel Therapeutics

“…Conventional laser therapy is performed using diode or argon. Cryotherapy has not been commonly used to treat ROP since late 1980s because it causes more inflammation than laser therapy [ 64 ]. Additionally, laser therapy was shown to achieve more favorable ocular outcomes than cryotherapy [ 65 , 66 ].…”

“…Therefore, treatments with a minimal destructive outcome are needed. When ROP aggravates to retinal detachment, ROP stage 4 or 5, surgery such as scleral buckling or vitrectomy can be performed to retain vision and reattach the retina [ 64 ].…”

Screening and Risk Factors for Retinopathy of Prematurity in a Tertiary Care Hospital in Cairo, Egypt

“…13 Interventions include laser photocoagulation, intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF), and/or vitreoretinal surgery for advanced cases. 14 …”

“…13 Interventions include laser photocoagulation, intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF), and/or vitreoretinal surgery for advanced cases. 14 Many studies were done to assess the prevalence and risk factors for ROP in different countries with various outcomes which suggest the need for development of local guidelines, with the reported prevalence rates ranging from 12.6% to 44.5%, [15][16][17][18] and that of treatment-requiring ROP ranging from 1.5% to 11.7% in other countries. [15][16][17][18] The aim of this study was to evaluate the ROP prevalence, screening, and risk factors in a tertiary hospital in Cairo, Egypt.…”

New insights in pediatrics in 2021: choices in allergy and immunology, critical care, endocrinology, gastroenterology, genetics, haematology, infectious diseases, neonatology, neurology, nutrition, palliative care, respiratory tract illnesses and telemedicine

“…Dani et al [ 105 ] conducted a study to assess incidence [ 106 ] and risk factors [ 107 , 108 ] for retinopathy of prematurity (ROP) development in preterm infants < 30 weeks gestational age, involving two neonatal intensive care units (NICUs) and 178 infants of which 67 (38%) developed any grade of ROP. Comparison of both the unaffected and affected by ROP sample (stage 1–2-3), using univariate and multivariable logistic regression analyses, allowed to identify maternal milk as protective and intraventricular hemorrhage and RBC transfusion as increasing risk factors for the development of ROP.…”