Evolving concepts in the management of retinopathy of prematurity

P Sternberg Jr, AK Durrani - American journal of ophthalmology, 2018 - Elsevier
P Sternberg Jr, AK Durrani
American journal of ophthalmology, 2018Elsevier
Purpose The introduction of anti–vascular endothelial growth factor (VEGF) agents has
stimulated considerable reexamination of treatment strategies for the management of
retinopathy of prematurity (ROP). Herein we summarize and review evolving concepts and
provide a personal perspective on clinical management today and future directions of
treatment. Design Literature review. Methods To synthesize the evolving management
concepts for diagnosis and treatment of retinopathy of prematurity and to provide …
Purpose
The introduction of anti–vascular endothelial growth factor (VEGF) agents has stimulated considerable reexamination of treatment strategies for the management of retinopathy of prematurity (ROP). Herein we summarize and review evolving concepts and provide a personal perspective on clinical management today and future directions of treatment.
Design
Literature review.
Methods
To synthesize the evolving management concepts for diagnosis and treatment of retinopathy of prematurity and to provide interpretation and perspective on current emerging therapies.
Results
Although initial treatment strategies focused on ablative therapy for threshold ROP, earlier treatment for type 1 or pre–threshold disease has been found to decrease unfavorable visual and structural outcomes. Vascular endothelial growth factor has emerged as a significant contributor to retinal-vascular diseases in the previous 2 decades. The potential role of anti-VEGF treatment for type 1 ROP has become a focus in recent years, but the protracted recurrence of disease and unknown adverse ocular and systemic effects have caused concern from some clinicians. In addition, the use of telemedicine technologies may provide the ability to screen remote areas with a shortage of ROP providers, thereby reducing the burden of disease.
Conclusions
The diagnosis and management of ROP has changed over the past 40 years; the role of anti-VEGF therapy remains to be established in current treatment strategies. Screening for initial disease and progression will likely be impacted by the increasing prevalence of telemedicine and relative shortage of clinicians.
Elsevier