RSS-Feed abonnieren
DOI: 10.1055/s-0040-1713181
Update in the Treatment of Retinopathy of Prematurity
Funding None.![](https://www.thieme-connect.de/media/ajp/202201/lookinside/thumbnails/10-1055-s-0040-1713181_190598-1.jpg)
Abstract
Retinopathy of prematurity (ROP) is an alteration in the development of the immature retina vascularization that frequently occurs in premature infants and is one of the leading causes of childhood blindness worldwide. In threshold stage retinopathy, laser photocoagulation is the standard treatment, particularly in those located in zone II. However, this therapy destroys parts of the retina and can lead to significant eye complications later in life. For this reason, in the last few years, antivascular endothelial growth factor agents are being used as monotherapy or as coadjuvant with laser, especially in retinopathy located in zone I. More recently, the administration of oral propranolol has been used as prevention and/or treatment of prethreshold retinopathy with encouraging results. This review provides an overview of the current evidence on newer treatment strategies for ROP.
Key Points
-
Laser is the standard treatment in threshold retinopathy of prematurity (ROP).
-
Prethreshold stages of the ROP have no treatment.
-
Propranolol may prevent the progression of ROP.
Publikationsverlauf
Eingereicht: 04. Oktober 2019
Angenommen: 11. Mai 2020
Artikel online veröffentlicht:
16. Juni 2020
© 2020. Thieme. All rights reserved.
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
-
References
- 1 Shah PK, Prabhu V, Karandikar SS, Ranjan R, Narendran V, Kalpana N. Retinopathy of prematurity: past, present and future. World J Clin Pediatr 2016; 5 (01) 35-46
- 2 Zin A, Gole GA. Retinopathy of prematurity-incidence today. Clin Perinatol 2013; 40 (02) 185-200
- 3 Gilbert C. Retinopathy of prematurity: a global perspective of the epidemics, population of babies at risk and implications for control. Early Hum Dev 2008; 84 (02) 77-82
- 4 Gilbert C, Fielder A, Gordillo L. et al; International NO-ROP Group. Characteristics of infants with severe retinopathy of prematurity in countries with low, moderate, and high levels of development: implications for screening programs. Pediatrics 2005; 115 (05) e518-e525
- 5 Vinekar A, Dogra MR, Sangtam T, Narang A, Gupta A. Retinopathy of prematurity in Asian Indian babies weighing greater than 1,250 grams at birth: ten year data from a tertiary care center in a developing country. Indian J Ophthalmol 2007; 55 (05) 331-336
- 6 Raghuveer TS, Bloom BT. A paradigm shift in the prevention of retinopathy of prematurity. Neonatology 2011; 100 (02) 116-129
- 7 Bancalari A, González R, Vásquez C, Pradenas I. Retinopathy of prematurity: incidence and associated factors. Rev Chil Pediatr 2000; 71: 114-121
- 8 International Committee for the Classification of Retinopathy of Prematurity. The international classification of retinopathy of prematurity revisited. Arch Ophthalmol 2005; 123 (07) 991-999
- 9 Early Treatment For Retinopathy Of Prematurity Cooperative Group. Revised indications for the treatment of retinopathy of prematurity: results of the early treatment for retinopathy of prematurity randomized trial. Arch Ophthalmol 2003; 121 (12) 1684-1694
- 10 Fierson WM. American Academy of Pediatrics Section on Ophthalmology, American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus, American Association of Certified Orthoptists. Screening examination of premature infants for retinopathy of prematurity. Pediatrics 2018; 142 (06) 1-9
- 11 Cavallaro G, Filippi L, Bagnoli P. et al. The pathophysiology of retinopathy of prematurity: an update of previous and recent knowledge. Acta Ophthalmol 2014; 92 (01) 2-20
- 12 Cayabyab R, Ramanathan R. Retinopathy of prematurity: therapeutic strategies based on pathophysiology. Neonatology 2016; 109 (04) 369-376
- 13 Cryotherapy for Retinopathy of Prematurity Cooperative Group. Multicenter trial of cryotherapy for retinopathy of prematurity. Preliminary results. Arch Ophthalmol 1988; 106 (04) 471-479
- 14 Laser ROP Study Group. Laser therapy for retinopathy of prematurity. Arch Ophthalmol 1994; 112 (02) 154-156
- 15 Hunter DG, Repka MX. Diode laser photocoagulation for threshold retinopathy of prematurity. A randomized study. Ophthalmology 1993; 100 (02) 238-244
- 16 McNamara JA, Tasman W, Vander JF, Brown GC. Diode laser photocoagulation for retinopathy of prematurity. Preliminary results. Arch Ophthalmol 1992; 110 (12) 1714-1716
- 17 Connolly BP, Ng EY, McNamara JA, Regillo CD, Vander JF, Tasman W. A comparison of laser photocoagulation with cryotherapy for threshold retinopathy of prematurity at 10 years: part 2. Refractive outcome. Ophthalmology 2002; 109 (05) 936-941
- 18 Ng EY, Connolly BP, McNamara JA, Regillo CD, Vander JF, Tasman W. A comparison of laser photocoagulation with cryotherapy for threshold retinopathy of prematurity at 10 years: part 1. Visual function and structural outcome. Ophthalmology 2002; 109 (05) 928-934 , discussion 935
- 19 Wallace DK, Wu KY. Current and future trends in treatment of severe retinopathy of prematurity. Clin Perinatol 2013; 40 (02) 297-310
- 20 Law JC, Recchia FM, Morrison DG, Donahue SP, Estes RL. Intravitreal bevacizumab as adjunctive treatment for retinopathy of prematurity. J AAPOS 2010; 14 (01) 6-10
- 21 Mintz-Hittner HA, Kennedy KA, Chuang AZ. BEAT-ROP Cooperative Group. Efficacy of intravitreal bevacizumab for stage 3+ retinopathy of prematurity. N Engl J Med 2011; 364 (07) 603-615
- 22 VanderVeen DK, Cataltepe SU. Antivascular endothelial growth factor intravitreal therapy for retinopathy of prematurity. Semin Perinatol 2019; 43 (06) 375-380
- 23 Shih T, Lindley C. Bevacizumab: an angiogenesis inhibitor for the treatment of solid malignancies. Clin Ther 2006; 28 (11) 1779-1802
- 24 FDA. Avastin approval history. U.S. Food and Drug Administration. Accessed October 7, 2012 at: http://www.accessdata.fda.gov/drugsatfda_docs/label/2009/125085s01691bl.pdf
- 25 Avery RL, Pearlman J, Pieramici DJ. et al. Intravitreal bevacizumab (Avastin) in the treatment of proliferative diabetic retinopathy. Ophthalmology 2006; 113 (10) 1695.e1-1695.e15
- 26 Bancalari A, Schade R, Peña R, Pavez N. Tratamiento de la retinopatía del prematuro con bevacizumab intravítreo. Rev Chil Pediatr 2013; 84: 300-307
- 27 Bancalari M A, Schade Y R, Peña Z R, Pavez P N. Intravitreal bevacizumab as single drug therapy for retinopathy of prematurity in 12 patients. Arch Argent Pediatr 2014; 112 (02) 160-163
- 28 Chung EJ, Kim JH, Ahn HS, Koh HJ. Combination of laser photocoagulation and intravitreal bevacizumab (Avastin) for aggressive zone I retinopathy of prematurity. Graefes Arch Clin Exp Ophthalmol 2007; 245 (11) 1727-1730
- 29 Travassos A, Teixeira S, Ferreira P. et al. Intravitreal bevacizumab in aggressive posterior retinopathy of prematurity. Ophthalmic Surg Lasers Imaging 2007; 38 (03) 233-237
- 30 Wallace DK, Dean TW, Hartnett ME. et al; Pediatric Eye Disease Investigator Group. A dosing study of bevacizumab for retinopathy of prematurity: late recurrences and additional treatments. Ophthalmology 2018; 125 (12) 1961-1966
- 31 Autrata R, Senková K, Holousová M, Krejcírová I, Dolezel Z, Borek I. [Effects of intravitreal pegaptanib or bevacizumab and laser in treatment of threshold retinopathy of prematurity in zone I and posterior zone II--four years results]. Cesk Slov Oftalmol 2012; 68 (01) 29-36
- 32 Gunay M, Sukgen EA, Celik G, Kocluk Y. Comparison of bevacizumab, ranibizumab, and laser photocoagulation in the treatment of retinopathy of prematurity in Turkey. Curr Eye Res 2017; 42 (03) 462-469
- 33 Sukgen EA, Kocluk Y. Comparison of clinical outcomes of intravitreal ranibizumab and aflibercept treatment for retinopathy of prematurity. Graefes Arch Clin Exp Ophthalmol 2019; 257 (01) 49-55
- 34 Kabataş EU, Kurtul BE, Altıaylık Özer P, Kabataş N. Comparison of intravitreal bevacizumab, intravitreal ranibizumab and laser photocoagulation for treatment of type 1 retinopathy of prematurity in Turkish preterm children. Curr Eye Res 2017; 42 (07) 1054-1058
- 35 Gunay M, Celik G, Gunay BO, Aktas A, Karatekin G, Ovali F. Evaluation of 2-year outcomes following intravitreal bevacizumab (IVB) for aggressive posterior retinopathy of prematurity. Arq Bras Oftalmol 2015; 78 (05) 300-304
- 36 Geloneck MM, Chuang AZ, Clark WL. et al; BEAT-ROP Cooperative Group. Refractive outcomes following bevacizumab monotherapy compared with conventional laser treatment: a randomized clinical trial. JAMA Ophthalmol 2014; 132 (11) 1327-1333
- 37 Stahl A, Lepore D, Fielder A. et al. Ranibizumab versus laser therapy for the treatment of very low birthweight infants with retinopathy of prematurity (RAINBOW): an open-label randomised controlled trial. Lancet 2019; 394 (10208): 1551-1559
- 38 Wu WCH, Lien R, Liao PJ. et al. Serum levels of vascular endothelial growth factor and related factors after intravitreous bevacizumab injection for retinopathy of prematurity. JAMA Ophthalmol 2015; 133 (04) 391-397
- 39 Li Z, Zhang Y, Liao Y, Zeng R, Zeng P, Lan Y. Comparison of efficacy between anti-vascular endothelial growth factor (VEGF) and laser treatment in Type-1 and threshold retinopathy of prematurity (ROP). BMC Ophthalmol 2018; 18 (01) 19
- 40 Jamrozy-Witkowska A, Kowalska K, Jankowska-Lech I, Terelak-Borys B, Nowosielska A, Grabska-Liberek I. [Complications of intravitreal injections--own experience]. Klin Oczna 2011; 113 (4-6): 127-131
- 41 Morrison D, Shaffer J, Ying GS, Binenbaum G. G-ROP Study Group. Ocular complications following treatment in the Postnatal Growth and Retinopathy of Prematurity (G-ROP) Study. J AAPOS 2018; 22 (02) 128-133
- 42 Honda S, Hirabayashi H, Tsukahara Y, Negi A. Acute contraction of the proliferative membrane after an intravitreal injection of bevacizumab for advanced retinopathy of prematurity. Graefes Arch Clin Exp Ophthalmol 2008; 246 (07) 1061-1063
- 43 Araz-Ersan B, Kir N, Tuncer S. et al. Preliminary anatomical and neurodevelopmental outcomes of intravitreal bevacizumab as adjunctive treatment for retinopathy of prematurity. Curr Eye Res 2015; 40 (06) 585-591
- 44 Morin J, Luu TM, Superstein R. et al; Canadian Neonatal Network and the Canadian Neonatal Follow-Up Network Investigators. Neurodevelopmental outcomes following bevacizumab injections for retinopathy of prematurity. Pediatrics 2016; 137 (04) e20153218
- 45 Kennedy KA, Mintz-Hittner HA. BEAT-ROP Cooperative Group. Medical and developmental outcomes of bevacizumab versus laser for retinopathy of prematurity. J AAPOS 2018; 22 (01) 61-65.e1
- 46 Austeng D, Källen KB, Hellström A, Tornqvist K, Holmström GE. Natural history of retinopathy of prematurity in infants born before 27 weeks' gestation in Sweden. Arch Ophthalmol 2010; 128 (10) 1289-1294
- 47 Chen YH, Lien RI, Tsai S. et al. Natural history of retinopathy of prematurity: two-year outcomes of a prospective study. Retina 2015; 35 (01) 141-148
- 48 Bancalari A, Schade R, Muñoz T, Lazcano C, Parada R, Peña R. Oral propranolol in early stages of retinopathy of prematurity. J Perinat Med 2016; 44 (05) 499-503
- 49 Lavine JA, Sang Y, Wang S, Ip MS, Sheibani N. Attenuation of choroidal neovascularization by β(2)-adrenoreceptor antagonism. JAMA Ophthalmol 2013; 131 (03) 376-382
- 50 Ristori C, Filippi L, Dal Monte M. et al. Role of the adrenergic system in a mouse model of oxygen-induced retinopathy: antiangiogenic effects of beta-adrenoreceptor blockade. Invest Ophthalmol Vis Sci 2011; 52 (01) 155-170
- 51 Casini G, Dal Monte M, Fornaciari I, Filippi L, Bagnoli P. The β-adrenergic system as a possible new target for pharmacologic treatment of neovascular retinal diseases. Prog Retin Eye Res 2014; 42: 103-129
- 52 Starkey E, Shahidullah H. Propranolol for infantile haemangiomas: a review. Arch Dis Child 2011; 96 (09) 890-893
- 53 Tang J, Li Z, Lu L, Cho CH. β-Adrenergic system, a backstage manipulator regulating tumour progression and drug target in cancer therapy. Semin Cancer Biol 2013; 23 (6 Pt B): 533-542
- 54 Filippi L, Dal Monte M, Casini G, Daniotti M, Sereni F, Bagnoli P. Infantile hemangiomas, retinopathy of prematurity and cancer: a common pathogenetic role of the β-adrenergic system. Med Res Rev 2015; 35 (03) 619-652
- 55 Lawley LP, Siegfried E, Todd JL. Propranolol treatment for hemangioma of infancy: risks and recommendations. Pediatr Dermatol 2009; 26 (05) 610-614
- 56 Léauté-Labrèze C, Hoeger P, Mazereeuw-Hautier J. et al. A randomized, controlled trial of oral propranolol in infantile hemangioma. N Engl J Med 2015; 372 (08) 735-746
- 57 Filippi L, Cavallaro G, Bagnoli P. et al. Oral propranolol for retinopathy of prematurity: risks, safety concerns, and perspectives. J Pediatr 2013; 163 (06) 1570-1577.e6
- 58 Makhoul IR, Peleg O, Miller B. et al. Oral propranolol versus placebo for retinopathy of prematurity: a pilot, randomised, double-blind prospective study. Arch Dis Child 2013; 98 (07) 565-567
- 59 Korkmaz L, Baştuğ O, Ozdemir A. et al. The efficacy of propranolol in retinopathy of prematurity and its correlation with the platelet mass index. Curr Eye Res 2017; 42 (01) 88-97
- 60 Sanghvi KP, Kabra NS, Padhi P, Singh U, Dash SK, Avasthi BS. Prophylactic propranolol for prevention of ROP and visual outcome at 1 year (PreROP trial). Arch Dis Child Fetal Neonatal Ed 2017; 102 (05) F389-F394
- 61 Filippi L, Cavallaro G, Bagnoli P. et al. Propranolol 0.1% eye micro-drops in newborns with retinopathy of prematurity: a pilot clinical trial. Pediatr Res 2017; 81 (02) 307-314
- 62 Filippi L, Cavallaro G, Berti E. et al. Propranolol 0.2% eye micro-drops for retinopathy of prematurity: a prospective phase IIB study. Front Pediatr 2019; 7: 180
- 63 Bancalari A, Schade R, Lazcano C. et al. Treatment of retinopathy of prematurity with propranolol: randomized control trial. E-PAS 2018; 2665
- 64 Hoeger PH, Harper JI, Baselga E. et al. Treatment of infantile haemangiomas: recommendations of a European expert group. Eur J Pediatr 2015; 174 (07) 855-865
- 65 Bührer C, Bassler D. Oral propranolol: a new treatment for infants with retinopathy of prematurity?. Neonatology 2015; 108 (01) 49-52
- 66 Kaempfen S, Neumann RP, Jost K, Schulzke SM. Beta-blockers for prevention and treatment of retinopathy of prematurity in preterm infants. Cochrane Database Syst Rev 2018; 3: CD011893
- 67 Stritzke A, Kabra N, Kaur S, Robertson HL, Lodha A. Oral propranolol in prevention of severe retinopathy of prematurity: a systematic review and meta-analysis. J Perinatol 2019; 39 (12) 1584-1594
- 68 Bührer C, Erdeve Ö, Bassler D, Bar-Oz B. Oral propranolol for prevention of threshold retinopathy of prematurity (ROPROP): protocol of a randomised controlled trial. BMJ Open 2018; 8 (07) e021749
- 69 Mills MD. STOP-ROP results suggest selective use of supplemental oxygen for prethreshold ROP. Arch Ophthalmol 2000; 118 (08) 1121-1122
- 70 Chen ML, Guo L, Smith LE, Dammann CE, Dammann O. High or low oxygen saturation and severe retinopathy of prematurity: a meta-analysis. Pediatrics 2010; 125 (06) e1483-e1492
- 71 The STOP-ROP Multicenter Study Group. Supplemental therapeutic oxygen for prethreshold retinopathy of prematurity (STOP-ROP), a randomized, controlled trial. I: primary outcomes. Pediatrics 2000; 105 (02) 295-310
- 72 Cayabyab R, Arora V, Wertheimer F, Durand M, Ramanathan R. Graded oxygen saturation targets and retinopathy of prematurity in extremely preterm infants. Pediatr Res 2016; 80 (03) 401-406
- 73 Colaizy TT, Longmuir S, Gertsch K, Abràmoff MD, Klein JM. Use of a supplemental oxygen protocol to suppress progression of retinopathy of prematurity. Invest Ophthalmol Vis Sci 2017; 58 (02) 887-891
- 74 Zhang X, Wang G, Liu B, Chen B, Yang H. Heated and humidified high flow nasal canal oxygen supplementation as an effective treatment for high-risk prethreshold retinopathy of prematurity. Transl Vis Sci Technol 2019; 8 (02) 20