Abstract
Retinopathy of prematurity (ROP) is one of the leading cause of preventable blindness in children. Its incidence increases with increasing survival of extremely preterm babies. ROP results from a multifactorial impairment of retinal development, the retinal vascular network, involving both oxygen-dependent and nutritional factors. The numerous factors involved in ROP development suggest that preventive strategies should be synergistic and complementary, including tight control of oxygen therapy, optimized nutritional intakes and postnatal growth, breastfeeding, adequate ω-3 PUFAs supply and control of hyperglycemic episodes associated with prematurity. ROP requires a multidisciplinary management, which includes systematic screening, appropriate treatment and long-term follow-up. Current screening modalities are based on wide-field digital retinal imaging systems, which also allow screening by telemedicine. The gold-standard treatment for ROP remains laser photocoagulation. It may be combined with intravitreal anti-VEGF administration, which is currently being evaluated, or surgery for advanced stages.
Highlights
The numerous factors involved in Retinopathy of prematurity (ROP) development suggest that preventive strategies should be synergistic and complementary, including tight control of oxygen therapy, optimized nutritional intakes and postnatal growth, breastfeeding, adequate ω-3 PUFAs supply and control of hyperglycemic episodes associated with prematurity
Current screening modalities are based on wide-field digital retinal imaging systems, which allow screening by telemedicine
The gold-standard treatment for ROP remains laser photocoagulation. It may be combined with intravitreal anti-VEGF administration, which is currently being evaluated, or surgery for advanced stages. ‡
Summary
AP-HP, 149 rue de Sèvres, 75015 Paris, France. Centre de recherche des Cordeliers, 15 rue de l’École de Médecine, 75006 Paris, France. AP-HP, 27 rue du Faubourg Saint-Jacques, 75014 Paris, France. Hyperoxie : stress oxydant, suppression de facteurs angiogéniques régulés par l’oxygène Facteurs nutritionnels : faible croissance, IGF-1 bas, hyperglycémie
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