Retinopathy of prematurity: a review of risk factors and their clinical significance

Abstract

Retinopathy of prematurity (ROP) is a retinal vasoproliferative disease that affects premature infants. Despite improvements in neonatal care and management guidelines, ROP remains a leading cause of childhood blindness worldwide. Current screening guidelines are primarily based on two risk factors: birth weight and gestational age; however, many investigators have suggested other risk factors, including maternal factors, prenatal and perinatal factors, demographics, medical interventions, comorbidities of prematurity, nutrition, and genetic factors. We review the existing literature addressing various possible ROP risk factors. Although there have been contradictory reports, and the risk may vary between different populations, understanding ROP risk factors is essential to develop predictive models, to gain insights into pathophysiology of retinal vascular diseases and diseases of prematurity, and to determine future directions in management of and research in ROP.

Incidence and risk factors for retinopathy of prematurity: a retrospective cohort study

“…These variations in the incidence of ROP may reflect differences in study populations, mortality rates, and characteristics of neonatal care in each institution, corroborating the need to further investigate the risk factors for the development of ROP. Numerous published case series have shown that infants with ROP in low- and middle-income nations have higher average BW and GA than infants with ROP in the United States [ 20 ]. Most studies report ROP incidences of about 60% for babies with less than 1500 g in nurseries of high-income countries [ 21 ].…”

Serine and 1-carbon metabolism are required for HIF-mediated protection against retinopathy of prematurity

“…Retinopathy of prematurity (ROP) is the most common form of infant blindness worldwide, accounting for 150,000 blind children annually (1). Survival after premature birth requires oxygen supplementation that is paradoxically associated with toxicity to premature developing tissues, such as the lung alveoli, nephrons of the kidney, cerebral cortex, and retinal capillaries (2).…”

Two-Year Outcomes of Infants with Stage 2 or Higher Retinopathy of Prematurity: Results from a Large Multicenter Registry

“…We found several factors were associated with treatment of ROP, including low birth weight, extreme premature birth, [19][20][21] exposure to higher levels of oxygen support, 22 and nosocomial sepsis. 23 We also identified exposure to erythropoietin alfa 21,24,25 and/or postnatal steroids 21,26 and severe apnea 27 as potential important factors promoting ROP disease progression. In addition, there are important comorbidities seen in infants who are treated for ROP.…”