The prenatal phase of retinopathy of prematurity

Abstract

Aim To explore the current literature on prenatal inflammation‐associated risk factors for retinopathy of prematurity (ROP). Methods Subjective summary of selected experimental and epidemiological publications that support the authors’ central hypothesis that the aetiology of ROP begins before birth. Results Based on current evidence we suggest that, contrary to current aetiological models, the process of ROP development begins with a prephase in utero. This beginning is likely initiated by inflammatory responses that are associated with intrauterine infection. Conclusion We propose a novel aetio‐pathogenetic model of ROP and suggest that the effects of postnatal exposure to inflammatory stressors (resulting from infection or hyperoxia or both) as well as those of other pre‐ and postnatal contributors to the complex pathogenesis of ROP might be modified by the prenatal phase of the disease.

Decoupling Oxygen Tension From Retinal Vascularization as a New Perspective for Management of Retinopathy of Prematurity. New Opportunities From β-adrenoceptors

“…Besides genetic predisposition, intrauterine inflammation including chorioamnionitis has also been demonstrated to be an important risk factor for ROP development (Villamor-Martinez et al, 2018). The strong correlation with intrauterine infections has suggested the hypothesis that already during the prenatal life the development of infections can trigger a very precocious phase of ROP by interfering with retinal vascularization (Dammann et al, 2021). In addition, some postnatal comorbidities of preterm infants, including bacterial (Tolsma et al, 2011;Lee and Dammann, 2012) or fungal sepsis (Noyola et al, 2002;Huang et al, 2019) (Chiang et al, 2021).…”

Hyperoxia combined with the B‐cell antagonist rituximab led to intestinal dysbiosis in neonatal mice

“…Hence the complications of neonatal hypoxia and oxygen therapy gain increasing attention. Premature retinopathy is a common neonatal disease characterized by retinal ischemia and massive neovascularization that occurs in premature infants or low‐weight full‐term babies 10 . The oxygen concentration is thought to be an important cause of premature retinopathy.…”

“…Premature retinopathy is a common neonatal disease characterized by retinal ischemia and massive neovascularization that occurs in premature infants or low-weight full-term babies. 10 The oxygen concentration is thought to be an important cause of premature retinopathy. Recently, rituximab has been used to treat retinopathy, such as retinal vasculitis, 11 retinal occlusive vasculopathy, 12 granulomatosis with polyangiitis, 13,14 and thyroid eye disease.…”

Abordaje y nuevas propuestas terapéuticas en la retinopatía del prematuro.

“…La presenLa retinopatía del prematuro (RDP) es una enfermedad multifactorial que se da al presentarse una alteración del desarrollo vascular de la retina inmadura exclusiva de los neonatos nacidos prematuros. (1) Su patogénesis depende de dos pilares: la hiperoxia relativa al nacer que frena la vascularización retiniana y la hipoxia resultante que genera un crecimiento excesivo arterial por medio de moduladores de angiogénesis (2).…”