Evolution of classification and treatment of retinopathy of prematurity: A review article

Abstract

Retinopathy of prematurity (ROP) is an ophthalmic condition found in premature infants, characterized by abnormal vascular growth in the retina. This article provides a comprehensive review of ROP, including its historical developments, classification systems, treatment modalities and emerging therapies. The pathophysiology of ROP involves the underdeveloped retinal blood vessels, which can lead to impaired retinal vascularization and subsequent complications. The classification of ROP is crucial for determining appropriate treatment approaches, and this review describes the various classification systems used to categorize the disease based on severity and retinal involvement. Treatment options for ROP have evolved over time. This article discusses the use of Vitamin E supplementation, cryotherapy and photocoagulation using lasers. The Early Treatment ROP Study (ETROP) is highlighted as a pivotal study that demonstrated the effectiveness of laser treatment in preventing retinal detachments. Furthermore, the use of intravitreal anti-vascular endothelial growth factors (VEGF) agents is explored as a promising approach. In addition to established treatments, this review delves into emerging therapies and experimental approaches. It explores the potential use of erythropoietin, recombinant insulin-like growth factor-1, subcutaneous cyclic peptide antagonists, regulatory T cells and beta-adrenergic blockers. The article emphasizes the ongoing research efforts in these areas and their potential impact on future ROP management. In conclusion, this comprehensive review highlights the historical developments, classification systems, current treatment options and emerging therapies for ROP. Continued research and advancements in the field are necessary to optimize treatment strategies and mitigate the long-term effects of ROP.