Abstract
Retinopathy of prematurity (ROP) is a leading cause of potentially preventable blindness in low birth weight preterm infants. Several perinatal and postnatal factors contribute to the incomplete maturation of retinal vascularization, leading to oxidative stress damage. Literature data suggest that the lack of equilibrium between pro-oxidants and anti-oxidants plays a key role. In the last decade, there has been an increasing interest in identifying the antecedents of ROP and the relevant pathogenic mechanisms involved. In this context, a panel of biomarkers was investigated in order to achieve early detection of oxidative stress occurrence and to prevent retinal damage. Several nutritional elements have been found to play a relevant role in ROP prevention. At this stage, no conclusive data have been shown to support the usefulness of one biomarker over another. Recently, the Food and Drugs Administration, the European Medicine Agency, and the National Institute of Health proposed a series of criteria in order to promote the inclusion of new biomarkers in perinatal clinical guidelines and daily practice. The aim of the present review is to offer an update on a panel of biomarkers, currently investigated as potential predictors of ROP, highlighting their strengths and weaknesses.
Highlights
Retinopathy of prematurity (ROP) is a pathology affecting the retina bloodstream, more frequently found in low birth weight preterm infants (LBWs)
Among different and various exogenous factors involved in the genesis of ROP, perinatal therapeutic strategies performed in the delivery room (DR) and in neonatal intensive care units (NICUs) have to be taken into due account
The retina is highly sensitive to lipid peroxidation as it is composed of lipids with high levels of polyunsaturated fatty acids (PUFAs), such as docosahexaenoic acid (DHA), cis-arachidonic acid, and choline phosphoglyceride [20,29]
Summary
Retinopathy of prematurity (ROP) is a pathology affecting the retina bloodstream, more frequently found in low birth weight preterm infants (LBWs). Pathological features of ROP are the onset of retinal ischemia, resulting in aberrant angiogenesis typically associated with fibrovascular proliferation, which may lead to progressive vitreoretinal traction In this light, endothelial components such as vascular endothelial growth factor (VEGF) are mainly involved in the cascade of events leading to pathological angiogenesis [12]. Among different and various exogenous factors involved in the genesis of ROP, perinatal therapeutic strategies performed in the delivery room (DR) and in neonatal intensive care units (NICUs) have to be taken into due account. This is especially true for oxygen by means of invasive or non-invasive mechanical respiratory strategies.
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