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2016 ; 8
(ä): 91-102
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Retinopathy of prematurity: the need for prevention
#MMPMID28539804
Liegl R
; Hellström A
; Smith LE
Eye Brain
2016[]; 8
(ä): 91-102
PMID28539804
show ga
More than 450,000 babies are born prematurely in the USA every year. The improved
survival of even the most vulnerable low body weight preterm infants has, despite
improving health outcomes, led to the resurgence in preterm complications
including one of the major causes for blindness in children, retinopathy of
prematurity (ROP). The current mainstay in ROP therapy is laser photocoagulation
and the injection of vascular endothelial growth factor (VEGF) antibodies in the
late stages of the disease after the onset of neovascularization. Both are proven
options for ophthalmologists to treat the severe forms of late ROP. However,
laser photocoagulation destroys major parts of the retina, and the injection of
VEGF antibodies, although rather simple to administer, may cause a systemic
suppression of normal vascularization, which has not been studied in sufficient
depth. However, the use of neither VEGF antibody nor laser treatment prevents
ROP, which should be the long-term goal. It should be possible to prevent ROP by
more closely mimicking the intrauterine environment after preterm birth. Such
preventive measures include preventing the toxic postbirth influences (eg, oxygen
excess) as well as providing the missing intrauterine factors (eg, insulin growth
factor 1) and are likely to also reduce other complications of premature birth as
well as ROP. This review is meant to summarize the current knowledge on the
prevention of ROP with a particular emphasize on the use of insulin growth factor
1 supplementation.
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