Combination of ROP treatments may help eliminate ‘destructive’ laser therapy

Retinopathy of prematurity is a disease in premature infants who today, secondary to advanced neonatal intensive care units, are surviving at ever lower birth weights and weeks of gestation. These infants almost universally require oxygen supplementation, and both excess oxygen and hypoxia can contribute to the disease.At about 16 weeks, the retina begins to develop vascularization, and this process is mediated by many cytokines and growth factors, including VEGF. The vessels grow outward from the optic nerve toward the retinal periphery, and this process is not fully completed in the temporal periphery until after full-term birth. The normal growth of blood vessels is directed toward relatively low oxygen areas of the retina. If excess oxygen is given, these normal blood vessels can fail to develop or regress. When the excess oxygen is removed, the blood vessels grow rapidly and are associated with fibrous tissue proliferation, which can also extend outside the retinal plane into the vitreous. Vitreous hemorrhage, retinal detachment, cataract, myopia, secondary glaucoma, strabismus and amblyopia are frequently associated with ROP.