Latest Trends in Retinopathy of Prematurity: Research on Risk Factors, Diagnostic Methods and Therapies

Abstract

Retinopathy of prematurity (ROP) is a vasoproliferative disorder with an imminent risk of blindness, in cases where early diagnosis and treatment are not performed. The doctors’ constant motivation to give these fragile beings a chance at life with optimal visual acuity has never stopped, since Terry first described this condition. Thus, throughout time, several specific advancements have been made in the management of ROP. Apart from the most known risk factors, this narrative review brings to light the latest research about new potential risk factors, such as: proteinuria, insulin-like growth factor 1 (IGF-1) and blood transfusions. Digital imaging has revolutionized the management of retinal pathologies, and it is more and more used in identifying and staging ROP, particularly in the disadvantaged regions by the means of telescreening. Moreover, optical coherence tomography (OCT) and automated diagnostic tools based on deep learning offer new perspectives on the ROP diagnosis. The new therapeutical trend based on the use of anti-VEGF agents is increasingly used in the treatment of ROP patients, and recent research sustains the theory according to which these agents do not interfere with the neurodevelopment of premature babies.

Video abstract

Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use:

https://youtu.be/eOpNaJS4Y7E

Keywords:

• retinopathy of prematurity
• risk factors
• optical coherence tomography
• telescreening
• artificial intelligence
• anti-VEGF

Abbreviations

ROP, retinopathy of prematurity; OCT, optical coherence tomography; VEGF, vascular endothelial growth factor; NICU, neonatal intensive care unit; BW, birth weight; GA, gestational age GA; HIF-1, hypoxia-inducible factor-1; AAP, American Academy of Pediatrics; PaO₂, partial oxygen pressure; IGF-1, insulin-like growth factor 1; PMA, postmenstrual age; IGFBP-3, IGF-binding protein 3; GMH-IVH, germinal matrix hemorrhage – intraventricular hemorrhage; AAO, American Academy of Ophthalmology; AI, artificial intelligence; DIAROP, Automated Deep Learning-Based Diagnostic Tool for Retinopathy of Prematurity; SD-OCT, spectral domain optical coherence tomography; ICROP, International Classification of Retinopathy of Prematurity; BEAT-ROP, Efficacy Study of Intravitreal Bevacizumab for Stage 3+ Retinopathy of Prematurity; VEGF-A, vascular endothelial growth factor A; VEGF-B, vascular endothelial growth factor B; kDa, kilodaltons; rhIGF-1, recombinant human insulin-like growth factor 1; RAINBOW, Ranibizumab Compared With Laser Therapy for the Treatment of Infants Born Prematurely With Retinopathy of Prematurity; rhIGFBP-3, recombinant human insulin-like growth factor binding protein-3; GRK5, G protein-coupled receptor kinase 5.

Acknowledgments

The authors wish to acknowledge that the present article was supported by ‘Dunarea de Jos’ University of Galati, Romania.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare no conflicts of interest.

Additional information

Funding

The present study was supported by the Doctoral School of Biomedical Sciences, ‘Dunarea de Jos’ University of Galati, Romania.