Pharmacologic interventions for the prevention and treatment of retinopathy of prematurity

Semin Perinatol. 2016 Apr;40(3):189-202. doi: 10.1053/j.semperi.2015.12.006. Epub 2016 Jan 29.

Abstract

Retinopathy of prematurity (ROP), a significant morbidity in prematurely born infants, is the most common cause of visual impairment and blindness in children and persists till adulthood. Strict control of oxygen therapy and prevention of intermittent hypoxia are the keys in the prevention of ROP, but pharmacologic interventions have decreased risk of ROP. Various drug classes such as methylxanthines (caffeine), VEGF inhibitors, antioxidants, and others have decreased ROP occurrence. The timing of pharmacologic intervention remains unsettled, but early prevention rather than controlling disease progression may be preferred. These drugs act through different mechanisms, and synergistic approaches should be considered to maximize efficacy and safety.

Keywords: Drug Interventions; Oxygen; Retinopathy of Prematurity.

Publication types

  • Review

MeSH terms

  • Antioxidants / pharmacology*
  • Caffeine / pharmacology*
  • Combined Modality Therapy
  • Disease Progression
  • Early Medical Intervention
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Oxygen Inhalation Therapy / methods*
  • Phosphodiesterase Inhibitors / pharmacology
  • Prognosis
  • Retinopathy of Prematurity* / diagnosis
  • Retinopathy of Prematurity* / metabolism
  • Retinopathy of Prematurity* / physiopathology
  • Retinopathy of Prematurity* / therapy
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors

Substances

  • Antioxidants
  • Phosphodiesterase Inhibitors
  • Vascular Endothelial Growth Factor A
  • Caffeine