Pathogenesis and Management of Retinopathy of Prematurity in Premature Infants
DOI:
https://doi.org/10.17140/PNNOJ-2-110Keywords:
ROP; Prematurity, VEGF; O2 Saturation; Neonate.Abstract
Retinopathy of Prematurity (ROP) continues to be a major cause of preventable blindness
in considerable parts of the world, including developing countries. The incidence of ROP
varies with the level of neonatal care; adequate screening and follow-up of these infants is
essential for intervention to occur at the appropriate time. Even though the pathophysiology
is not certain, oxygen and its interaction with angiogenic factors plays a central role in the
development of the disease. Despite the role of oxygen in the pathogenesis of ROP, optimal
oxygen saturation in the first few weeks of life in the premature infant remains unclear. Current
treatment strategies include ablation of the peripheral avascular retina, management of abnormal
vasoproliferation in late stages of disease and visual rehabilitation. A team effort involving
neonatologists, ophthalmologists and excellent nursing care will go a long way in not only decreasing
the incidence of ROP but also in building a strong screening and follow-up program,
which is critical in the management of these patients.
References
Good WV, Hardy RJ, Dobson V, et al. The incidence and course of retinopathy of prematurity: findings from the early treatment for retinopathy of prematurity study. Pediatrics. 2005; 116(1): 15-23. doi: 10.1542/peds.2004-1413
Gilbert C. Retinopathy of prematurity: a global perspective of the epidemics, population of babies at risk and implications for control. Early human development. 2008; 84(2): 77-82.
Hartnett ME, Penn JS. Mechanisms and management of reti-nopathy of prematurity. N Engl J Med. 2012; 367(26): 2515- 2526. doi: 10.1056/NEJMra1208129
Fruttiger M. Development of the retinal vasculature. Angio-genesis. 2007; 10(2): 77-88. 10.1007/s10456-007-9065-1
Ashton N. Retinal angiogenesis in the human embryo. British medical bulletin. 1970; 26(2): 103-106.
Shah VA, Yeo CL, Ling YL, Ho LY. Incidence, risk factors of retinopathy of prematurity among very low birth weight infants in Singapore. Annals of the Academy of Medicine, Singapore. 2005; 34(2): 169-178.
Dani C, Reali MF, Bertini G, Martelli E, Pezzati M, Rubaltelli FF. The role of blood transfusions and iron intake on retinopathy of prematurity. Early human development. 2001; 62(1): 57-63. doi: 10.1016/S0378-3782(01)00115-3
Mittal M, Dhanireddy R, Higgins RD. Candida sepsis and association with retinopathy of prematurity. Pediatrics. 1998; 101(4 Pt 1): 654-657.
Kinsey VE. Retrolental fibroplasia; cooperative study of ret-rolental fibroplasia and the use of oxygen. AMA archives of oph-thalmology. 1956; 56(4): 481-543.
Lanman JT, Guy LP, Dancis J. Retrolental fibroplasia and oxygen therapy. Journal of the American Medical Association. 1954; 155(3): 223-226. 10.1001/jama.1954.03690210001001
Patz A, Hoeck LE, De La Cruz E. Studies on the effect of high oxygen administration in retrolental fibroplasia. I. Nursery observations. American journal of ophthalmology. 1952; 35(9): 1248-1253.
Tin W, Milligan DW, Pennefather P, Hey E. Pulse oximetry, severe retinopathy, and outcome at one year in babies of less than 28 weeks gestation. Archives of disease in childhood Fe-tal and neonatal edition. 2001;84(2): F106-F110. doi: 10.1136/ fn.84.2.F106
Chen ML, Guo L, Smith LE, Dammann CE, Dammann O. High or low oxygen saturation and severe retinopathy of prema-turity: a meta-analysis. Pediatrics. 2010; 125(6): e1483-e1492. doi: 10.1542/peds.2009-2218
Network SSGotEKSNNR, Carlo WA, et al. Target ranges of oxygen saturation in extremely preterm infants. N Engl J Med. 2010; 362(21): 1959-1969. doi: 10.1056/NEJMoa0911781
Group BIUKC, Group BIAC, Group BINZC, et al. Oxygen saturation and outcomes in preterm infants. N Engl J Med. 2013; 368(22): 2094-2104. doi: 10.1056/NEJMoa1302298
Schmidt B, Whyte RK, Asztalos EV, et al. Effects of target-ing higher vs lower arterial oxygen saturations on death or dis-ability in extremely preterm infants: a randomized clinical trial. JAMA: the journal of the American Medical Association. 2013; 309(20): 2111-2120. doi: 10.1001/jama.2013.5555
Phelps DL. Reduced severity of oxygen-induced retinopathy in kittens recovered in 28% oxygen. Pediatr Res. 1988; 24(1): 106-109. doi: 10.1203/00006450-198807000-00024
Phelps DL, Rosenbaum AL. Effects of marginal hypoxemia on recovery from oxygen-induced retinopathy in the kitten mod-el. Pediatrics. 1984; 73(1): 1-6.
The STOP-ROP Multicenter Study Group. Supplemental Therapeutic Oxygen for Prethreshold Retinopathy Of Prema-turity (STOP-ROP), a randomized, controlled trial. I: primary outcomes. Pediatrics. 2000; 105(2): 295-310.
International Committee for the Classification of Retinopa-thy of Prematurity. An international classification of retinopathy of prematurity. The Committee for the Classification of Retinop-athy of Prematurity. Archives of ophthalmology. 1984; 102(8): 1130-1134. doi: 10.1001/archopht.1984.01040030908011
Fierson WM, American Academy of Pediatrics Section on O, American Academy of O, American Association for Pediatric O, Strabismus, American Association of Certified O. Screening examination of premature infants for retinopathy of prematurity. Pediatrics. 2013; 131(1): 189-195. doi: 10.1542/peds.2012-
Multicenter trial of cryotherapy for retinopathy of prema-turity. Preliminary results. Cryotherapy for Retinopathy of Pre-maturity Cooperative Group. Archives of ophthalmology. 1988; 106(4): 471-479.
Cryotherapy for Retinopathy of Prematurity Cooperative G. Multicenter Trial of Cryotherapy for Retinopathy of Prematu-rity: ophthalmological outcomes at 10 years. Archives of oph-thalmology. 2001; 119(8): 1110-1118.
Connolly BP, McNamara JA, Sharma S, Regillo CD, Tasman W. A comparison of laser photocoagulation with trans-scleral cryotherapy in the treatment of threshold retinopathy of prema-turity. Ophthalmology. 1998;105(9): 1628-1631. doi: 10.1016/ S0161-6420(98)99029-7
Early Treatment For Retinopathy Of Prematurity Coopera-tive G. Revised indications for the treatment of retinopathy of prematurity: results of the early treatment for retinopathy of prematurity randomized trial. Archives of ophthalmology. 2003; 121(12): 1684-1694. doi: 10.1001/archopht.121.12.1684
Mintz-Hittner HA, Kennedy KA, Chuang AZ, Group B-RC. Efficacy of intravitreal bevacizumab for stage 3+ retinopathy of prematurity. N Engl J Med. 2011; 364(7): 603-615. doi: 10.1056/ NEJMoa1007374
Mantagos IS, Vanderveen DK, Smith LE. Emerging treat-ments for retinopathy of prematurity. Seminars in ophthalmol-ogy. 2009; 24(2): 82-86. doi: 10.1080/08820530902800322
Lofqvist C, NiklassonA, Engstrom E, et al.Apharmacokinetic and dosing study of intravenous insulin-like growth factor-I and IGF-binding protein-3 complex to preterm infants. Pediatr Res. 2009; 65(5): 574-579. doi: 10.1203/PDR.0b013e31819d9e8c
Ristori C, Filippi L, Dal Monte M, et al. Role of the adren-ergic system in a mouse model of oxygen-induced retinopathy: antiangiogenic effects of beta-adrenoreceptor blockade. Investi-gative ophthalmology & visual science. 2011; 52(1): 155-170. doi: 10.1167/iovs.10-5536
Filippi L, Cavallaro G, Bagnoli P, et al. Oral propranolol for retinopathy of prematurity: risks, safety concerns, and perspec-tives. The Journal of pediatrics. 2013; 163(6): 1570-1577 e6. doi: 10.1016/j.jpeds.2013.07.049
Filippi L, Cavallaro G, Fiorini P, et al. Study protocol: safety and efficacy of propranolol in newborns with Retinopathy of Prematurity (PROP-ROP): ISRCTN18523491. BMC pediatrics. 2010; 10: 83. doi: 10.1186/1471-2431-10-83
SanGiovanni JP, Chew EY. The role of omega-3 long-chain polyunsaturated fatty acids in health and disease of the retina. Progress in retinal and eye research. 2005; 24(1): 87-138. doi: 10.1016/j.preteyeres.2004.06.002
Kermorvant-Duchemin E, Sennlaub F, Sirinyan M, et al. Trans-arachidonic acids generated during nitrative stress in-duce a thrombospondin-1-dependent microvascular degenera-tion. Nature medicine. 2005; 11(12): 1339-1345. doi: 10.1038/ nm1336
Connor KM, SanGiovanni JP, Lofqvist C, et al. Increased dietary intake of omega-3-polyunsaturated fatty acids reduces pathological retinal angiogenesis. Nature medicine. 2007; 13(7): 868-873. doi: 10.1038/nm1591
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
All content published in Pediatrics and Neonatal Nursing (PNN) is licensed under the Creative Commons Attribution 4.0 International License (CC BY 4.0). This license allows anyone to copy, distribute, transmit, and adapt the work — including for commercial purposes — provided appropriate credit is given to the original author(s) and source.
