Laser Therapy Versus Anti-VEGF Agents for Treatment of Retinopathy of Prematurity.
نویسندگان
چکیده
Retinopathy of prematurity (ROP) is characterized by abnormal retinal neurovascular development that occurs in preterm infants. Although in high-income countries up to 8% of childhood blindness is due to ROP, in middle-income countries this number rises to 40%. Moreover, as methods to ensure survival of preterm infants improve, the prevalence of ROP continues to increase. Worldwide, approximately 10% of births occur before the full gestational age defined as 37 weeks. The risk of developing ROP is inversely proportional to the infant’s gestational age and to its weight at the time of delivery, with most cases occurring in infants born at earlier than 28 weeks of gestation and weighing <1251 g. Although studies looking at ROP prevalence in various developed-world countries differ in the selection criteria for the infants at risk, incidence of any ROP ranges from 33% to 73%, whereas severe ROP was reported in 10% to 26% of patients. Understanding the pathology of ROP and its current treatments requires an understanding of the normal retinal vascular development. Retinal angiogenesis in humans begins at approximately 16th week of gestation, with vessels growing from the optic disc radially outwards. Normally, new vessels grow out from existing ones until they reach the ora serrata at around the time of full-term birth. In utero, the development of the sensory retina outpaces that of the retinal vasculature, and the resulting physiological hypoxia leads to the secretion of vasoactive factors such as vascular endothelial growth factor (VEGF), which, in turn, stimulate blood vessel growth. Premature birth, however, can disrupt normal retinal development and result in ROP. Two phases of ROP have been described. Phase I is characterized by the arrest of normal retinal vessel growth after a
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Anti-VEGF therapy in the management of retinopathy of prematurity: what we learn from representative animal models of oxygen-induced retinopathy
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ورودعنوان ژورنال:
- International ophthalmology clinics
دوره 55 4 شماره
صفحات -
تاریخ انتشار 2015