Retinopathy of Prematurity in the 21st Century and the Complex Impact of Supplemental Oxygen

Sarah H Rodriguez; Anna L Ells; Michael P Blair; Parag K Shah; C Armitage Harper 3rd; Maria Ana Martinez-Castellanos; S Grace Prakalapakorn; Erima Denis; Rebecca C Lusobya; Mark J Greenwald; Sherwin J Isenberg; Scott R Lambert; Yvonne E Vaucher; Ann Carroll; Lucy Namakula

doi:10.3390/jcm12031228

Retinopathy of Prematurity in the 21st Century and the Complex Impact of Supplemental Oxygen

J Clin Med. 2023 Feb 3;12(3):1228. doi: 10.3390/jcm12031228.

Authors

Sarah H Rodriguez¹, Anna L Ells², Michael P Blair^{1

3}, Parag K Shah⁴, C Armitage Harper 3rd⁵, Maria Ana Martinez-Castellanos⁶, S Grace Prakalapakorn^{7

8}, Erima Denis^{9

10}, Rebecca C Lusobya^{11

12}, Mark J Greenwald¹, Sherwin J Isenberg¹³, Scott R Lambert¹⁴, Yvonne E Vaucher¹⁵, Ann Carroll¹⁶, Lucy Namakula¹⁷

Affiliations

¹ Department of Ophthalmology and Visual Science, University of Chicago Medical Center, Chicago, IL 60637, USA.
² Calgary Retina Consultants, Department of Surgery, University of Calgary, Calgary, AB T2H 0C8, Canada.
³ Retina Consultants, Ltd., Des Plaines, IL 60016, USA.
⁴ Department of Vitreous & Retina, Aravind Eye Hospital, Coimbatore 641014, India.
⁵ Austin Retina Associates, Austin, TX 78705, USA.
⁶ Asociación Para Evitar la Ceguera En Mexico, Hospital "Luis Sáchez Bulnes" I.A.P. Department of Pediatric Retina, Mexico City 04030, Mexico.
⁷ Department of Ophthalmology and Pediatrics, Duke University Medical Center, Durham, NC 27710, USA.
⁸ Duke Global Health Institute, Duke University Medical Center, Durham, NC 27710, USA.
⁹ Lubaga Hospital, Kampala P.O. Box 14130, Uganda.
¹⁰ Masaka Regional Referral Hospital, Kampala P.O. Box 7272, Uganda.
¹¹ Department of Ophthalmology, School of Medicine, College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda.
¹² Mulago National Referral Hospital, Kampala P.O. Box 7051, Uganda.
¹³ Jules Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA.
¹⁴ Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, CA 94305, USA.
¹⁵ Division of Neonatology, Department of Pediatrics, University of California San Diego, San Diego, CA 92037-7774, USA.
¹⁶ Independent Researcher, Roseville, MN 55113, USA.
¹⁷ St. Francis Hospital Nsambya, Kampala P.O. Box 7146, Uganda.

Abstract

Retinopathy of prematurity (ROP) is a leading cause of childhood blindness. Not only do the epidemiologic determinants and distributions of patients with ROP vary worldwide, but clinical differences have also been described. The Third Edition of the International Classification of ROP (ICROP3) acknowledges that aggressive ROP (AROP) can occur in larger preterm infants and involve areas of the more anterior retina, particularly in low-resource settings with unmonitored oxygen supplementation. As sub-specialty training programs are underway to address an epidemic of ROP in sub-Saharan Africa, recognizing characteristic retinal pathology in preterm infants exposed to unmonitored supplemental oxygen is important to proper diagnosis and treatment. This paper describes specific features associated with various ROP presentations: oxygen-induced retinopathy in animal models, traditional ROP seen in high-income countries with modern oxygen management, and ROP related to excessive oxygen supplementation in low- and middle-income countries: oxygen-associated ROP (OA-ROP).

Keywords: childhood blindness; global health; global ophthalmology; ophthalmology; oxygen; oxygen-associated retinopathy of prematurity; oxygen-induced retinopathy; pediatric blindness; retinopathy of prematurity; retrolental fibroplasia.

Grants and funding

P30 EY026877/EY/NEI NIH HHS/United States