EC Microbiology

Review Article Volume 18 Issue 12 - 2022

Retinopathy of Prematurity Epidemiology, Diagnosis, and Management

Hani Abdullah Al Hashmi1*, Mohammed Ahmed Alghamdi2, Alaa Khalid Bahashwan3, Ayat Hassan Zilai4, Fathiah Mohammed Etaiwi5, Mohammad Ali Aljumaiah6, Moath Ibrahim Almontashiri7, Renad Abdulkadir Mtbouli8, Mosaad Abdullah Alqarni1, Feher Mohammed Alturkistani1, Ahmed Sameer Munshi1, Eman Kamal Eskander9, Turki Falah Turki Almutairi10 and Khadijah Jadah Asiri11

1King Abdulaziz Hospital, Jeddah, Saudi Arabia

2Al-Baha University, Albaha, Saudi Arabia

3King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia

4King Salman Hospital, Riyadh, Saudi Arabia

5King Abdullah Medical Complex, Jeddah, Saudi Arabia

6Security Forces Hospital, Riyadh, Saudi Arabia

7Saudi German Hospital, Jeddah, Saudi Arabia

8King Abdulaziz University Hospital, Jeddah, Saudi Arabia

9King Fahad Hospital, Jeddah, Saudi Arabia

10Diabetic Centre, Hafar Albtin, Saudi Arabia

11Ahad Rufaidah General Hospital, Asir, Saudi Arabia

*Corresponding Author: Hani Abdullah Al Hashmi, Pediatric Consultant, Allergist and Immunologist, King Abdulaziz Hospital, Jeddah, Saudi Arabia.
Received: November 19, 2022; Published: November 24, 2022

Introduction: Retinopathy of prematurity (ROP) is a disease that threatens the eyesight of preterm and low-birthweight infants. Historically the disease was more common in developed countries, but now its occurrence has increased in developing countries as well. The disease progresses in two phases, namely vaso-occlusion and vaso-proliferation. Various risk factors exist for ROP, according to which criteria for the screening are developed in different countries. Diagnosis is usually made by using an ophthalmoscope and graded according to the amount of vaso-proliferation. Based on grading, treatment may be carried out medically, surgically, and most commonly, by using LASER.

Aim of Work: The aim of this study is to review retinopathy of prematurity.

Materials and Methods: Comprehensive research of retinopathy of prematurity epidemiology, Etiopathogenesis, and management. PUBMED search engines were the primary database used for the search process from the year 1988 to 2022.

Conclusion: Despite decades of research, retinopathy of prematurity continues to be a trial for neonatal ophthalmologists. As maternity healthcare improves across the globe, more cases of ROP are emerging. Several treatment strategies exist that significantly reduce the occurrence of ROP, but they also carry risks of complications. Preventive measures with better maternal healthcare, early detection with modern biomarkers, and timely intervention with appropriate therapy can improve the lives of thousands of voiceless infants.


Keywords: Retinopathy of Prematurity; Premature Infant; Vasoproliferative Eye Disease; Low Birth Weight

  1. Shah PK., et al. “Retinopathy of prematurity: Past, present and future”. World Journal of Clinical Pediatrics1 (2016): 35.
  2. Silverman WA. “A cautionary tale about supplemental oxygen: the albatross of neonatal medicine”. Pediatrics-Springfield2 (2004): 394-397.
  3. Quinn G E., et al. “Incidence and early course of retinopathy of prematurity: secondary analysis of the postnatal growth and retinopathy of prematurity (G-ROP) study”. JAMA Ophthalmology12 (2018): 1383-1389.
  4. Austeng D., et al. “Incidence of retinopathy of prematurity in infants born before 27 weeks' gestation in Sweden”. Archives of Ophthalmology10 (2009): 1315-1319.
  5. Markestad T., et al. “Early death, morbidity, and need of treatment among extremely premature infants”. Pediatrics5 (2005): 1289-1298.
  6. Allegaert K., et al. “Threshold retinopathy at threshold of viability: the EpiBel study”. British Journal of Ophthalmology2 (2004): 239-242.
  7. Bowe T., et al. “The current state of retinopathy of prematurity in India, Kenya, Mexico, Nigeria, Philippines, Romania, Thailand, and Venezuela”. Digital Journal of Ophthalmology: DJO4 (2019): 49.
  8. Jang JH and Kim YC. “Retinal vascular development in an immature retina at 33-34 weeks postmenstrual age predicts retinopathy of prematurity”. Scientific Reports1 (2020): 1-8.
  9. Smith LE. “Pathogenesis of retinopathy of prematurity”. Seminars in Neonatology6 (2003): 469-473.
  10. Hellström A., et al. “Retinopathy of prematurity”. The Lancet9902 (2013): 1445-1457.
  11. Smith LE., et al. “Regulation of vascular endothelial growth factor-dependent retinal neovascularization by insulin-like growth factor-1 receptor”. Nature Medicine12 (1999): 1390-1395.
  12. Anderson CG., et al. “Retinopathy of prematurity and pulse oximetry: a national survey of recent practices”. Journal of Perinatology3 (2004): 164-168.
  13. SUPPORT Study Group of the Eunice Kennedy Shriver NICHD Neonatal Research Network. “Target ranges of oxygen saturation in extremely preterm infants”. New England Journal of Medicine21 (2010): 1959-1969.
  14. Hellstrom A., et al. “Postnatal serum insulin-like growth factor I deficiency is associated with retinopathy of prematurity and other complications of premature birth”. Pediatrics5 (2003): 1016-1020.
  15. Mitchell AJ., et al. “Physiologic effects of retinopathy of prematurity screening examinations”. Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses4 (2011): 291.
  16. Molinari A., et al. “Classifying retinopathy of prematurity”. Community Eye Health99 (2017): 55.
  17. Tan W., et al. “Novel Potential Biomarkers for Retinopathy of Prematurity”. Frontiers in Medicine (2022): 143.
  18. Nilsson AK., et al. “Sphingolipidomics of serum in extremely preterm infants: Association between low sphingosine-1-phosphate levels and severe retinopathy of prematurity”. Biochimica et Biophysica Acta (BBA)-Molecular and Cell Biology of Lipids7 (2021): 158939.
  19. Woo SJ., et al. “Inflammatory and angiogenic mediators in amniotic fluid are associated with the development of retinopathy of prematurity in preterm infants”. Investigative Ophthalmology and Visual Science5 (2020): 42-42.
  20. Metin T., et al. “Evaluation of the plasma microRNA levels in stage 3 premature retinopathy with plus disease: preliminary study”. Eye2 (2018): 415-420.
  21. Mammas IN and Spandidos DA. “Retinopathy of prematurity and neonatal gut microbiome: An interview with Professor Dimitra Skondra, Associate Professor of Ophthalmology and Vitreoretinal Surgeon at The University of Chicago (USA)”. Experimental and Therapeutic Medicine6 (2020): 1-1.
  22. Hansen ED and Hartnett ME. “A review of treatment for retinopathy of prematurity”. Expert Review of Ophthalmology2 (2019): 73-87.
  23. Cryotherapy for Retinopathy of Prematurity Cooperative Group. “Multicenter trial of cryotherapy for retinopathy of prematurity: preliminary results”. Pediatrics5 (1988): 697-706.
  24. Dhawan A., et al. “Structural sequelae and refractive outcome after successful laser treatment for threshold retinopathy of prematurity”. Journal of Pediatric Ophthalmology and Strabismus6 (2008): 356-361.
  25. Li Z., et al. “Comparison of efficacy between anti-vascular endothelial growth factor (VEGF) and laser treatment in Type-1 and threshold retinopathy of prematurity (ROP)”. BMC Ophthalmology1 (2018): 1-10.
  26. Kondo H., et al. “Late recurrence of retinal detachment following successful vitreous surgery for stages 4B and 5 retinopathy of prematurity”. American Journal of Ophthalmology4 (2009): 661-666.

Hani Abdullah Al Hashmi., et al. “Retinopathy of Prematurity Epidemiology, Diagnosis, and Management”. EC Microbiology  18.12 (2022): 51-59.