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Retinopathy of Prematurity

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Retinal and Choroidal Angiogenesis
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Abstract

Retinopathy of prematurity (ROP) develops in the incompletely vascularized eyes of premature infants, beginning with injury to the developing vessels. It commonly heals through neovascularization but may lead to retinal detachment and vision loss. Understanding the pathophysiology and clinical course can provide clues to guide investigators in ROP prevention and control.

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References

  1. E. A. Palmer, J. T. Flynn, R. J. Hardy, D. L. Phelps, C. L. Phillips, D. B. Schaffer, B. Tung on behalf of the Cryotherapy for Retinopathy of Prematurity Cooperative Group, Incidence and early course of retinopathy of prematurity, Ophthalmology 98(11), 1628-1640 (1991).

    PubMed  CAS  Google Scholar 

  2. W. V. Good, R. J. Hardy, V. Dobson, E. A. Palmer, D. L. Phelps, M. Quintos, B. Tung, The incidence and course of retinopathy of prematurity: findings from the early treatment for retinopathy of prematurity study, Pediatrics 116(1), 15-23 (2005).

    Article  PubMed  Google Scholar 

  3. J. A. Lemons, C. R. Bauer, W. Oh, S. B. Korones, L. Papile, B. J. Stoll, J. Verter, M. Temprosa, L. L. Wright, R. A. Ehrenkranz, A. A. Fanaroff, A. R. Stark, W. A. Carlo, J. E. Tyson, E. F. Donovan, S. Shankaran, D. K. Stevenson, Very-low-birth-weight outcomes of the NICHD Neonatal Research Network, January 1995 through December 1996, Pediatrics 107(1), e1-e10 (2001).

    Article  PubMed  CAS  Google Scholar 

  4. Early Treatment for Retinopathy of Prematurity Cooperative Group. Revised indications for the treatment of retinopathy of prematurity. Results of the early treatment for retinopathy of prematurity randomized trial, Arch. Ophthalmol. 121(12), 1684-1696 (2003).

    Article  PubMed  CAS  Google Scholar 

  5. Unpublished Data from the NIH/ NICHD Neonatal Research Network: birth years 2001-2003. 12% of infants of 23-28 weeks gestation were treated with laser surgery for ROP prior to discharge. (Used with permission).

    Google Scholar 

  6. D. L. Phelps, Retinopathy of Prematurity, In Neonatal-Perinatal Medicine: Diseases of the Fetus and Infant. 7th ed., edited by A. A. Fanaroff, R. J. Martin, (Mosby-YearBook, St. Louis Missouri, 2001).

    Google Scholar 

  7. Cryotherapy for Retinopathy of Prematurity Cooperative Group, Multicenter trial of cryotherapy for retinopathy of prematurity: preliminary results, Arch. Ophthalmol. 106(4), 471-479 (1988).

    Google Scholar 

  8. R. S. Wagner, Increased incidence and severity of retinopathy of prematurity in developing nations, J. Pediatr. Ophthalmol. Strabismus 40(4), 193 (2003).

    PubMed  Google Scholar 

  9. J. D. Reynolds, V. Dobson, Q. E. Quinn, A. R. Fielder, E. A. Palmer, R. A. Saunders, R. J. Hardy, D. L. Phelps, J. Baker, M. R. Trese, D. Schaffer, B. Tung, Evidenced-based screening criteria for retinopathy of prematurity: natural history data from the CRYO-ROP and LIGHT-ROP studies, Arch. Ophthalmol. 120(11), 1470-1476 (2002).

    PubMed  Google Scholar 

  10. D. B. Roth, D. Morales, W. J. Feuer, D. Hess, R. A. Johnson, J. T. Flynn, Screening for retinopathy of prematurity employing the Retcam 120: sensitivity and specificity, Arch. Ophthalmol. 119(2), 268-272 (2001).

    PubMed  CAS  Google Scholar 

  11. Committee on Fetus and Newborn, American Academy of Pediatric Policy Statement. Age terminology during the perinatal period, Pediatrics 114(5), 1362-1364 (2004).

    Article  Google Scholar 

  12. Cryotherapy for Retinopathy of Prematurity Cooperative Group. Multicenter trial of cryotherapy for retinopathy of prematurity: 3raise.5exscriptstyle 1kern-.1em/ kern-.15emlower.25exscriptstyle 2 -year outcome–structure and function, Arch. Ophthalmol. 111(3), 339-344 (1993).

    Google Scholar 

  13. D. B. Schaffer, E. A. Palmer, D. F. Plotsky, H. S. Metz, J. T. Flynn, B. Tung, R. J. Hardy, on behalf of The Cryotherapy for Retinopathy of Prematurity Cooperative Group, Prognostic factors in the natural course of retinopathy of prematurity (ROP), Ophthalmology 100(2), 230-37 (1993).

    PubMed  CAS  Google Scholar 

  14. T. Chan-Ling, B. Gock, J. Stone, The effect of oxygen on vasoformative cell division. Evidence that ‘physiological hypoxia’ is the stimulus for normal retinal vasculogenesis, Invest. Ophthalmol. Vis. Sci. 36(7), 1201-1214 (1995).

    PubMed  CAS  Google Scholar 

  15. F. L. Kretzer, H. M. Hittner, Spindle cells and retinopathy of prematurity: interpretations and predictions, in Retinopathy of Prematurity: Problem and Challenge , edited by J.T. Flynn and D.L. Phelps. March of Dimes Birth Defects: Original Article Series 24(1), 147-168 (1988).

    Google Scholar 

  16. V. Seiberth, O. Linderkamp, Risk factors in retinopathy of prematurity - A multivariate statistical analysis, Ophthalmologica 214(2), 131-135 (2000).

    Article  PubMed  CAS  Google Scholar 

  17. T. R. Gunn, J. Easdown, E. W. Outerbridge, J. V. Aranda, Risk factors in retrolental fibroplasia, Pediatrics 65(6), 1096-1100 (1980).

    PubMed  CAS  Google Scholar 

  18. R. Aggarwal, A. K. Deorari, R. V. Azad, H. Kumar, D. Talwar, A. Sethi, V. K. Paul, Changing profile of retinopathy of prematurity, J. Trop. Pediatr. 48(4), 239-242 (2002).

    Article  PubMed  Google Scholar 

  19. D. L. Phelps, Retinopathy of prematurity: History, classification, and pathophysiology, NeoReviews 2(July), e153-e166 (2001).

    Article  Google Scholar 

  20. H. C. Fledelius, Central nervous system damage and retinopathy of prematurity - An ophthalmic follow-up of prematures born in 1982-84, Acta. Paediatr. 85(10), 1186-1191 (1996).

    Article  PubMed  CAS  Google Scholar 

  21. G. E. Quinn, V. Dobson, M. X. Repka, J. Reynolds, J. Kivlin, B. Davis, E. Buckley, J. T. Flynn, E. A. Palmer, on behalf of the Cryotherapy for Retinopathy of Prematurity Cooperative Group. Development of myopia in infants with birth weights less than 1251 grams, Ophthalmology 99(3), 329-340 (1992).

    PubMed  CAS  Google Scholar 

  22. CRYO-ROP Multicenter Study Group, 15 year outcomes following threshold retinopathy of prematurity: Final results from the multicenter trial of cryotherapy, Arch. Ophthalmol. 123(3), 311-318 (2005).

    Article  Google Scholar 

  23. V. Dobson, G. E. Quinn, C. G. Summers, R. A. Saunders, D. L. Phelps, B. Tung, E. A. Palmer, on behalf of the Cryotherapy for Retinopathy of Prematurity Cooperative Group, Effect of acute-phase retinopathy of prematurity on grating acuity development in the very low birth weight infant, Invest. Ophthalmol. Vis. Sci. 35(13), 4236-4244 (1994).

    PubMed  CAS  Google Scholar 

  24. D. L. Mayer, A. S. Beiser, A. F. Warner, E. M. Pratt, K. N. Raye, J. M. Lang, Monocular acuity norms for the Teller acuity cards between ages one month and four years, Invest. Ophthalmol. Vis. Sci. 36(3), 671-685 (1995).

    PubMed  CAS  Google Scholar 

  25. Cryotherapy for Retinopathy of Prematurity Cooperative Group. Effect of retinal ablative therapy for threshold retinopathy of prematurity: results of Goldmann perimetry at the age of 10 years, Arch. Ophthalmol. 119(8), 1120-1125 (2001).

    Google Scholar 

  26. M. T. Trese, Scleral buckling for retinopathy of prematurity, Ophthalmology 101(1), 23-26 (1994).

    PubMed  CAS  Google Scholar 

  27. G. E. Quinn, V. Dobson, C. C. Barr, B. R. Davis, J. T. Flynn, E. A. Palmer, J. Robertson, M. T. Trese, Visual acuity in infants after vitrectomy for severe retinopathy of prematurity, [published erratum appears in Ophthalmology 98(7), 1005 (1991)] Ophthalmology 98(1), 5-13 (1991).

    PubMed  CAS  Google Scholar 

  28. G. E. Quinn, V. Dobson, C. C. Barr, B. R. Davis, E. A. Palmer, J. Robertson, C. G. Summers, M. T. Trese, B. Tung for the Cryotherapy for Retinopathy of Prematurity Cooperative Group, Visual acuity of eyes after vitrectomy for retinopathy of prematurity: follow-up at 5 1/2 years, Ophthalmology 103(4), 595-600 (1996).

    PubMed  CAS  Google Scholar 

  29. M. T. Trese, P. J. Droste, Long term postoperative results of a consecutive series of stages 4 and 5 retinopathy of prematurity, Ophthalmology 105(6), 992-997 (1998).

    Article  PubMed  CAS  Google Scholar 

  30. A. J. Capone, M. T. Trese, Lens-sparing vitreous surgery for tractional stage 4A retinopathy of prematurity retinal detachments, Ophthalmology 108(11), 2068-2070 (2001).

    Article  PubMed  Google Scholar 

  31. I. C. Michaelson, Retinal Circulation in Man and Animals, (Charles C Thomas publisher, Springfield Illinois, 1954).

    Google Scholar 

  32. S. Hughes, H. Yang, T. Chan-Ling, Vascularization of the human fetal retina: roles of vasculogenesis and angiogenesis, Invest. Ophthalmol. Vis. Sci. 41(5), 1217-1228 (2000).

    PubMed  CAS  Google Scholar 

  33. T. Chan-Ling, D. S. McLeod, S. Hughes, L. Baxter, Y. Chu, T. Hasegawa, G. A. Lutty, Astrocyte-endothelial cell relationships during human retinal vascular development, Invest. Ophthalmol. Vis. Sci. 45(6), 2020-2032 (2004).

    Article  PubMed  Google Scholar 

  34. T. Chan-Ling, M. P. Page, T. Gardiner, L. Baxter, E. Rosinova, S. Hughes, Desmin ensheathment ratio as an indicator of vessel stability: evidence in normal development and in retinopathy of prematurity, Am. J. Pathol. 165(4), 1301-1313 (2004).

    PubMed  CAS  Google Scholar 

  35. C. W. Nichols, C. Lambertsen, Effects of high oxygen pressures on the eye, New Engl. J. Med. 281(1), 25-30 (1969).

    Article  PubMed  CAS  Google Scholar 

  36. M. L. Donahue, D. L. Phelps, R. H. Watkins, M. B. Lomonaco, S. Horowitz, Retinal vascular endothelial growth factor (VEGF) mRNA expression is altered in relation to neovascularization in oxygen induced retinopathy, Curr. Eye Res. 15(2), 175-184 (1996).

    Article  PubMed  CAS  Google Scholar 

  37. M. X. Repka, E. A. Palmer, B. Tung, on Behalf of the Cryotherapy for Retinopathy of Prematurity Cooperative Group. Involution of retinopathy of prematurity, Arch. Ophthalmol. 118(5), 645-649 (2000).

    PubMed  CAS  Google Scholar 

  38. http://www.nei.nih.gov/photo/search/keyword.asp?keyword=rop Video ‘cartoon’ of the development of ROP (2003).

    Google Scholar 

  39. W. A. Silverman, Retrolental Fibroplasia. A Modern Parable(Grune & Stratton, New York, 1980).

    Google Scholar 

  40. International Committee for Classification of ROP. An international classification of retinopathy of prematurity. II. The classification of retinal detachment, [published erratum appears in Arch. Ophthalmol. 105(11), 1498 (1987)], Arch. Ophthalmol. 105(7), 906-912 (1987).

    Google Scholar 

  41. V. E. Kinsey, J. T. Jacobus, F. M. Hemphill, Retrolental fibroplasia: cooperative study of retrolental fibroplasia and the use of oxygen, Arch. Ophthalmol. 56, 481-547 (1956).

    CAS  Google Scholar 

  42. E. Bancalari, J. Flynn, R. N. Goldberg, R. Bawol, J. Cassady, J. Schiffman, W. Feuer, J. Roberts, D. Gillings, E. Sim, Influence of transcutaneous oxygen monitoring on the incidence of retinopathy of prematurity, Pediatrics 79(5), 663-669 (1987).

    PubMed  CAS  Google Scholar 

  43. L. C. Chow, K. W. Wright, A. Sola, CSMC oxygen administration group, Can changes in clinical practice decrease the incidence of severe retinopathy of prematurity in very low birth weight infants? Pediatrics 111(2), 339-345 (2003).

    Article  PubMed  Google Scholar 

  44. W. Tin, D. W. Milligan, P. Pennefather, E. Hey, Pulse oximetry, severe retinopathy, and outcome at one year in babies of less than 28 weeks gestation, Arch. Dis. Child. Fetal Neo. Ed. 84(2), F106-F110 (2001).

    Article  CAS  Google Scholar 

  45. W. Tin, U. Wariyar, Giving small babies oxygen: 50 years of uncertainty, Semin. Neonatol. 7(5), 361-367 (2002).

    Article  PubMed  Google Scholar 

  46. C. H. Cole, K. W. Wright, W. Tarnow-Mordi, D. L. Phelps, on behalf of the POST-ROP Study Planning Group, Resolving our uncertainty about oxygen therapy, Pediatrics 112(6), 1415-1418 (2003).

    Article  PubMed  Google Scholar 

  47. Committee of the Institute of Medicine, Division of Health Sciences Policy. Report of a study. Vitamin E and retinopathy of prematurity, (National Academic Press, Washington, DC, 2101 Constitution Ave., NW, Washington, IOM-86-02, 1986).

    Google Scholar 

  48. S. C. Shih, M. Ju, N. Liu, L. E. H. Smith, Selective stimulation of VEGFR-1 prevents oxygen-induced retinal vascular degeneration in retinopathy of prematurity [comment], J. Clin. Invest. 112(1), 50-57 (2003).

    Article  PubMed  CAS  Google Scholar 

  49. L. C. Shaw, M. B. Grant, Insulin like growth factor-1 and insulin-like growth factor binding proteins: their possible roles in both maintaining normal retinal vascular function and in promoting retinal pathology, Rev. Endocr. Metab. Disord. 5(3), 199-207 (2004).

    Article  PubMed  CAS  Google Scholar 

  50. A. Hellstrom, C. Perruzzi, M. Ju, E. Engstrom, A-L. Hard, J-L. Liu, K. Albertsson-Wikland, B. Carlsson, A. Niklasson, L. Sjodell, D. LeRoith, D. R. Senger, L. E. H. Smith, Low IGF-I suppresses VEGF-survival signaling in retinal endothelial cells: Direct correlation with clinical retinopathy of prematurity, Proc. Natl. Acad. Sci. USA 98(10), 5804-5808 (2001).

    Google Scholar 

  51. J. Stone, T. Chan-Ling, J. Pe’er, A. Itin, H. Gnessin, E. Keshet, Roles of vascular endothelial growth factor and astrocyte degeneration in the genesis of retinopathy of prematurity, Invest. Ophthalmol. Vis. Sci. 37(2), 290-299 (1996).

    PubMed  CAS  Google Scholar 

  52. J. D. Reynolds, R. J. Hardy, K. A. Kennedy, R. Spencer, W. A. J. van Heuven, A. R. Fielder, for the Light Reduction in Retinopathy of Prematurity (LIGHT-ROP) Cooperative Group, Lack of efficacy of light reduction in preventing retinopathy of prematurity, N. Engl. J. Med. 38(22), 1572-1576 (1998).

    Article  Google Scholar 

  53. D. L. Phelps, J. L. Watts. Early light reduction to prevent retinopathy of prematurity in very low birth weight infants. Neonatal Module of The Cochrane Database of Systematic Reviews, The Cochrane Library. (Disk) Issue 1, Oxford: Update Software (2001).

    Google Scholar 

  54. L. Lakatos, Z. Lakatos, I. Hatvani, G. Oroszlan, Controlled trial of use of d-penicillamine to prevent retinopathy of prematurity in very low- birth-weight infants, in Physiologic Foundations of Perinatal Care, edited by L. Stern, W. Oh, B. Friis-Hansen, (Elsevier, 1987) pp9-23.

    Google Scholar 

  55. D. L. Phelps, L. Lakatos, J. L. Watts, D-Penicillamine to prevent retinopathy of prematurity. Neonatal Module of The Cochrane Database of Systematic Reviews, The Cochrane Library; (Disk) Issue 1, Oxford: Update Software (2001).

    Google Scholar 

  56. M. Hallman, A-L. Jarvenpaa, M. Pohjavuori, Respiratory distress syndrome and inositol supplementation in preterm infants, Arch. Dis. Child. 61, 1076-1083 (1986).

    Article  PubMed  CAS  Google Scholar 

  57. M. Hallman, K. Bry, K. Hoppu, M. Lappi, M. Pohjavuori, Inositol supplementation in premature infants with respiratory distress syndrome, N. Engl. J. Med. 326(19), 1233-1239 (1992).

    Article  PubMed  CAS  Google Scholar 

  58. A. Howlett, A. Ohlsson, Inositol for respiratory distress syndrome in preterm infants (Cochrane Review). In: The Cochrane Library,Issue 2, Oxford: Update Software (2002).

    Google Scholar 

  59. B. P. Connolly, J. A. McNamara, S. Sharma, C. D. Regillo, W. Tasman, A comparison of laser photocoagulation with trans-scleral cryotherapy in the treatment of threshold retinopathy of prematurity, Ophthalmology 105(9), 1628-1631 (1998).

    Article  PubMed  CAS  Google Scholar 

  60. D. G. Hunter, M. X. Repka, Diode laser photocoagulation for threshold retinopathy of prematurity. A randomized study, Ophthalmology 100(2), 238-244 (1993).

    PubMed  CAS  Google Scholar 

  61. J. A. McNamara, W. Tasman, J. F. Vander, G. C. Brown, Diode laser photocoagulation for retinopathy of prematurity. Preliminary results, Arch. Ophthalmol. 110(12), 1714-1716 (1992).

    PubMed  CAS  Google Scholar 

  62. E. A. Pierce, E. D. Foley, L. E. H Smith, Regulation of vascular endothelial growth factor by oxygen in a model of retinopathy of prematurity, Arch. Ophthalmol. 114(10), 1219-1228 (1996).

    PubMed  CAS  Google Scholar 

  63. D. L. Phelps, Reduced severity of oxygen-induced retinopathy in kittens recovered in 28% oxygen, Pediatr. Res. 24(1), 106-109 (1998).

    Google Scholar 

  64. STOP-ROP Multicenter Study Group, Supplemental therapeutic oxygen for prethreshold retinopathy of prematurity (STOP-ROP), a Randomized Controlled Trial. I: primary outcomes, Pediatrics 105(2), 295-310 (2000).

    Article  Google Scholar 

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Phelps, D.L. (2008). Retinopathy of Prematurity. In: Penn, J. (eds) Retinal and Choroidal Angiogenesis. Springer, Dordrecht. https://doi.org/10.1007/978-1-4020-6780-8_19

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