Retinal vascular damages are the cardinal hallmarks of retinopathy of prematurity (ROP), a leading cause of vision impairment and blindness in childhood. Both angiogenesis and vasculogenesis are disrupted in the hyperoxia-induced vaso-obliteration phase, and recapitulated, although aberrantly, in the subsequent ischemia-induced neovessel formation phase of ROP. Yet, whereas the histopathological features of ROP are well characterized, many key modulators with a therapeutic potential remain unknown. The CCN1 protein also known as cysteine-rich protein 61 (Cyr61) is a dynamically expressed, matricellular protein required for proper angiogenesis and vasculogenesis during development. The expression of CCN1 becomes abnormally reduced during the hyperoxic and ischemic phases of ROP modeled in the mouse eye with oxygen-induced retinopathy (OIR). Lentivirus-mediated re-expression of CCN1 enhanced physiological adaptation of the retinal vasculature to hyperoxia and reduced pathological angiogenesis following ischemia. Remarkably, injection into the vitreous of OIR mice of hematopoietic stem cells (HSCs) engineered to express CCN1 harnessed ischemiainduced neovessel outgrowth without adversely affecting the physiological adaptation of retinal vessels to hyperoxia. In vitro exposure of HSCs to recombinant CCN1 induced integrin-dependent cell adhesion, migration, and expression of specific endothelial cell markers as well as many components of the Wnt signaling pathway including Wnt ligands, their receptors, inhibitors, and downstream targets. CCN1-induced Wnt signaling mediated, at least in part, adhesion and endothelial differentiation of cultured HSCs, and inhibition of Wnt signaling interfered with normalization of the retinal vasculature induced by CCN1-primed HSCs in OIR mice. These newly identified functions of CCN1 suggest its possible therapeutic utility in ischemic retinopathy.Retinopathy of prematurity (ROP), 2 a leading cause of visual impairment in low birth weight infants, is initiated by delayed retinal vascular growth and insufficient vascularization after premature birth (1). A disrupted oxygen environment in the retina of severely premature neonates is a key factor in the onset of retinal vaso-obliteration and the development of ROP. Retinal ischemia is the underlying cause triggering the release of angiogenic factors that promote the formation of aberrant vessels, which then break through the inner limiting membrane into the vitreous causing vitreous hemorrhage, tractional retinal detachment, and vision loss.The normal retinal vasculature, which is planar in nature, is well organized into three capillary plexuses generated during retinal development in a well coordinated manner. Conversely, pathological neovascularization generates disorganized, leaky, and tortuous vessels prone to exudation, hemorrhage, and fibrosis that damage the retina ultimately causing blindness. The collective work of many investigators has resulted in a greater appreciation of the pathogenic factors involved (2-5). The balance be...