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Review
. 2020 Oct;36(10):900-907.
doi: 10.1051/medsci/2020163. Epub 2020 Oct 7.

[Retinopathy of prematurity: from prevention to treatment]

[Article in French]
Alejandra Daruich  1 , Dominique Bremond-Gignac  1 , Francine Behar-Cohen  2 , Elsa Kermorvant  3
Affiliations
Free article
Review

[Retinopathy of prematurity: from prevention to treatment]

[Article in French]
Alejandra Daruich et al. Med Sci (Paris). 2020 Oct.
Free article

Abstract
in English, French

Retinopathy of prematurity (ROP) is one of the leading cause of preventable blindness in children. Its incidence increases with increasing survival of extremely preterm babies. ROP results from a multifactorial impairment of retinal development, the retinal vascular network, involving both oxygen-dependent and nutritional factors. The numerous factors involved in ROP development suggest that preventive strategies should be synergistic and complementary, including tight control of oxygen therapy, optimized nutritional intakes and postnatal growth, breastfeeding, adequate ω-3 PUFAs supply and control of hyperglycemic episodes associated with prematurity. ROP requires a multidisciplinary management, which includes systematic screening, appropriate treatment and long-term follow-up. Current screening modalities are based on wide-field digital retinal imaging systems, which also allow screening by telemedicine. The gold-standard treatment for ROP remains laser photocoagulation. It may be combined with intravitreal anti-VEGF administration, which is currently being evaluated, or surgery for advanced stages.

Title: Rétinopathie du prématuré : de la prévention au traitement.

Abstract: La rétinopathie du prématuré (ROP) est la principale cause évitable de cécité infantile. Son incidence augmente avec la survie de nouveau-nés extrêmement prématurés. La ROP est une pathologie multi-factorielle du développement de la rétine et du réseau vasculaire rétinien, impliquant des facteurs oxygéno-dépendants et nutritionnels. La multiplicité des facteurs participant à la survenue de la ROP plaide en faveur de stratégies préventives complémentaires et synergiques, telles que le contrôle rigoureux de l’oxygénothérapie, l’optimisation des apports nutritionnels et de la croissance post-natale, l’allaitement maternel, un apport suffisant en AGPI-ω-3 et le contrôle des épisodes hyperglycémiques liés à la prématurité. La ROP nécessite une prise en charge multidisciplinaire, qui inclut un dépistage systématique, un traitement adapté et un suivi à long terme. Les modalités actuelles de dépistage font appel à une caméra grand-champ, permettant également un dépistage par télémédecine. Le traitement de référence de la ROP demeure la photocoagulation au laser. Il peut être associé à des injections intravitréennes d’anticorps anti-VEGF, en cours d’évaluation, ou à la chirurgie pour les stades avancés.

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References

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