Retinopathy of prematurity (ROP) is a vasoproliferative disorder of the premature retina with the potential to progress to extraretinal neovascularisation. This review serves as an introduction to retinopathy of prematurity (ROP), outlining key parts of ROP pathophysiology, diagnosis and treatment. ROP is traditionally diagnosed by indirect ophthalmoscopy and classified using anatomical zones, stages of disease, and the presence or absence of “plus disease” (dilation and tortuosity of the major retinal arterioles and venules). ROP has a bi-phasic pathophysiology: initial hyperoxia causes reduced retinal vascularisation, followed by pathological vaso-proliferation resulting from subsequent hypoxia and driven by vascular endothelial growth factor (VEGF). This review summarises previous trials to establish optimum oxygen exposure levels in newborns and more recently the development of anti-VEGF agents locally delivered to block pathological neovascularisation, which is technically easier to administer and less destructive than laser treatment. There remains an ongoing concern regarding the potential unwanted systemic effects of intravitreally administered anti-VEGF on the overall development of the premature baby. Ongoing dosing studies may lessen these fears by identifying the minimally effective dose required to block extraretinal neovascularisation.

中文翻译：

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早产儿视网膜病变：从氧气管理到分子操纵

早产儿视网膜病变 (ROP) 是一种早产儿视网膜血管增生性疾病，有可能发展为视网膜外新生血管。本综述介绍了早产儿视网膜病变 (ROP)，概述了 ROP 病理生理学、诊断和治疗的关键部分。ROP 传统上通过间接检眼镜检查进行诊断，并根据解剖区域、疾病阶段以及是否存在“附加疾病”（主要视网膜小动脉和小静脉的扩张和扭曲）进行分类。ROP 具有双相病理生理学：最初的高氧导致视网膜血管形成减少，随后由随后的缺氧引起并由血管内皮生长因子 (VEGF) 驱动的病理性血管增殖。这篇综述总结了之前建立新生儿最佳氧暴露水平的试验，以及最近开发的局部递送抗 VEGF 药物以阻止病理性新生血管形成，这在技术上更容易管理，并且比激光治疗破坏性更小。人们仍然担心玻璃体内注射抗 VEGF 对早产儿的整体发育可能产生不良的全身影响。正在进行的剂量研究可以通过确定阻止视网膜外新生血管形成所需的最低有效剂量来减轻这些担忧。