New insights in diagnosis and treatment for Retinopathy of Prematurity

Int Ophthalmol. 2016 Oct;36(5):751-60. doi: 10.1007/s10792-016-0177-8. Epub 2016 Jan 14.

Abstract

The purpose of this study was to review current perspectives on diagnosis and treatment of Retinopathy of Prematurity (ROP). We performed a systematic review of how much has been produced in research published online and on print regarding ROP in different settings around the world. Early Treatment for ROP (ETROP) classification is the currently accepted classification of ROP. Fluorescein angiography and spectral domain optical coherence tomography (SD-OCT) may eventually lead to changes in the definition of ROP, and as a consequence, they will serve as a guide for treatment. Intravitreal anti-VEGF therapy has proven to be more effective in terms of lowering recurrence, allowing growth of the peripheral retina, and diminishing the incidence of retinal detachment when proliferative ROP is diagnosed. Whether anti-VEGF plus laser are better than any of these therapies separately remains a subject of discussion. Telemedicine is evolving everyday to allow access to remote areas that do not count with a retina specialist for treatment. A management algorithm is proposed according to our reference center experience. ROP is an evolving subject, with a vulnerable population of study that, once treated with good results, leads to a reduction in visual disability and in consequence, in a lifetime improvement.

Keywords: Aflibercept; Algorithm; Angiography; Bevacizumab; Guidelines; Laser; Ranibizumab; Retinopathy of prematurity; Telemedicine; Tomography; Vitrectomy.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Angiogenesis Inhibitors / therapeutic use
  • Fluorescein Angiography
  • Humans
  • Infant
  • Infant, Newborn
  • Laser Coagulation
  • Retinopathy of Prematurity / classification
  • Retinopathy of Prematurity / diagnosis*
  • Retinopathy of Prematurity / therapy*
  • Tomography, Optical Coherence
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Vitrectomy

Substances

  • Angiogenesis Inhibitors
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A