Abstract
Retinopathy of prematurity (ROP) is an ocular vascular disease affecting premature infants, characterized by pathological retinal neovascularization (RNV), dilated and tortuous retinal blood vessels, and retinal or vitreous hemorrhages that may lead to retinal detachment, vision impairment and blindness. Compared with other neovascular diseases, ROP is unique because of ongoing and concurrent physiological and pathological angiogenesis in the developing retina. While the disease is currently treated by laser or cryotherapy, anti-vascular endothelial growth factor (VEGF) agents have been extensively investigated but are not approved in the U.S. because of safety concerns that they negatively interfere with physiological angiogenesis of the developing retina. An ideal therapeutic strategy would selectively inhibit pathological but not physiological angiogenesis. Our group recently described a novel strategy that selectively and safely alleviates pathological RNV in animal models of ROP by targeting secretogranin III (Scg3), a disease-restricted angiogenic factor. The preclinical profile of anti-Scg3 therapy presents a high potential for next-generation disease-targeted anti-angiogenic therapy for the ROP indication. This review focuses on retinal vessel development in neonates, the pathogenesis of ROP and its underlying molecular mechanisms, including different animal models, and provides a summary of current and emerging therapies.
Highlights
Retinopathy of prematurity (ROP) with pathological retinal neovascularization (RNV)is the most common cause of blindness in children, primarily afflicting preterm infants [1].During ROP, abnormal retinal blood vessels form sprouts and branches that extend over the retinal surface and into the vitreous as they progress to pathological RNV and intravitreal neovascularization (IVNV) [2]
ROP first appeared as a clinical disorder in the 1940s, coincident with the liberal use of supplemental oxygen to improve the survival of preterm infants with respiratory distress syndrome (RDS) [3]
The results revealed an advantage of intravitreal bevacizumab over laser therapy for Stage 3+ ROP infants with Zone I but not Zone II disease
Summary
Retinopathy of prematurity (ROP) with pathological retinal neovascularization (RNV). is the most common cause of blindness in children, primarily afflicting preterm infants [1]. Retinopathy of prematurity (ROP) with pathological retinal neovascularization (RNV). In contrast to other ocular neovascular diseases, including proliferative diabetic retinopathy (DR) with RNV and wet age-related macular degeneration (AMD) with choroidal neovascularization (CNV), ROP in the developing retina of premature infants is unique because of the coexistence of physiological and pathological angiogenesis. The former is essential for normal retinal development. 1. Fundus image of retinopathy of of prematurity retwith tortuous arteries and dilated veins as plus disease.
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