Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Oct:218:208-213.
doi: 10.1016/j.ajo.2020.05.025. Epub 2020 May 23.

Retinopathy of Prematurity: Evolving Treatment With Anti-Vascular Endothelial Growth Factor

M Elizabeth Hartnett  1
Affiliations
Review

Retinopathy of Prematurity: Evolving Treatment With Anti-Vascular Endothelial Growth Factor

M Elizabeth Hartnett. Am J Ophthalmol. 2020 Oct.

Erratum in

Abstract

Purpose: To discuss the evolution in retinopathy of prematurity since its first description as retrolental fibroplasia in the United States, including the changes in the understanding of pathophysiology; methods of diagnosis; destructive, anti-vascular endothelial growth factor (anti-VEGF), and supportive treatments; and differences in retinopathy of prematurity manifestations worldwide. The overall goal is to clarify retinopathy of prematurity currently and formulate questions to optimize future care.

Study design: Literature review and synthesis.

Methods: Critical review and consideration of the literature with inclusion of historical articles and those regarding pathophysiologic risk factors, retinopathy of prematurity worldwide, basic and clinical science particularly regarding anti-VEGF mechanisms and agents tested in clinical trials.

Results: Retinopathy of prematurity has evolved from affecting infants approximately 2 months premature to affecting extremely premature infants. Worldwide, retinopathy of prematurity differs and, in emerging countries, has features similar to that experienced in the United States when retinopathy of prematurity first manifested. Treatments have evolved from destruction of the peripheral avascular retina to inhibit angiogenic stimuli to anti-VEGF agents, which inhibit pathologic angiogenesis but also extend normal intraretinal angiogenesis by ordering the development of intraretinal vessels. Clinical trial evidence is accruing with the goal to develop less destructive treatments to optimize vision and that are protective to the retina and infant.

Conclusions: Goals for retinopathy of prematurity are to optimize prenatal and perinatal care, improve diagnostic acumen worldwide and refine treatment strategies, including with anti-VEGF agents, to inhibit intravitreal angiogenesis and facilitate vascularization of the previously avascular retina, which include supporting neural and vascular development of the premature infant and retina.

PubMed Disclaimer

References

    1. Terry TL. rhIGF-1/rhIGFBP-3 in Preterm Infants: A Phase 2 Randomized Controlled Trial. American Journal of Ophthalmology. 1942;25:203–204.
    1. Darlow BA, Gilbert C. Retinopathy of prematurity - A world update. Semin Perinatol. 2019;43(6):315–316. - PubMed
    1. Hartnett ME, Penn JS. Mechanisms and Management of Retinopathy of Prematurity. N Engl J Med. 2012;367(26):2515–2526. - PMC - PubMed
    1. Shah P, Narendran V, Kalpana N, Gilbert C. Severe retinopathy of prematurity in big babies in India: History repeating itself? Indian J Pediatr. 2009;76(8):801–804. - PubMed
    1. Ells AL, Holmes JM, Astle WF, et al. Telemedicine approach to screening for severe retinopathy of prematurity: a pilot study. Ophthalmology. 2003;110(11):2113–2117. - PubMed

Publication types

MeSH terms