THE ROLE OF VARIOUS REGULATORY FACTORS IN PATHOLOGICAL VASOPROLIFERATION IN THE RETINOPATHY OF PREMATURITY

Abstract

Retinopathy of prematurity continues to occupy one of the leading positions in the structure of vision disability among the children. The problem of optimizing the prognosis of this condition, its early diagnostics, and adequate treatment remains a serious challenge and is inextricably connected with the better understanding of the pathogenesis of this disease. It is known that the mechanism underlying the development of retinopathy of prematurity involves the imbalance between the angiogenic factors controlling the process of growth and development of blood vessels in the immature retinal tissue in the combination with the biochemical and immunological disturbances of homeostasis in the prematurely born infants as a result of systemic somatic pathology and the unfavourable multifactorial influence of the environmental conditions, in the first place the effect of elevated oxygen concentrations used for the nursing the preterm babies. A large number of papers have been devoted to the study of various factors contributing to the development of retinopathy in preterm patients at the molecular level. For the purpose of the present review, the search for the relevant literature was carried out using the Medline database. The role of the vascular endothelial growth factor (VEGF-A) and insulin-like growth factor-1 (IGF-1) in the development of pathological vasoproliferation associated with retinopathy of prematurity has been most thoroughly explored. Information about the role of VEGF-A in the pathogenesis of the disease provided the basis for the use of anti-VEGF therapy in the clinical practice for the treatment of certain forms of retinopathy. However, the complicated and multifactorial character of the pathogenesis of this disease as well as the need for the enhancement of the effectiveness of its treatment and optimization of the screening procedure dictates the necessity of looking for additional approaches to the solution of this problem and of studying the relationships between various factors involved in the disturbance of retinal angiogenesis in the children presenting with retinopathy of prematurity.