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Assessment and management of retinopathy of prematurity in the era of anti-vascular endothelial growth factor (VEGF).
Prog Retin Eye Res. 2021 Nov 09 [Online ahead of print]PR

Abstract

The incidence of retinopathy of prematurity (ROP) continues to rise due to the improved survival of very low birth weight infants in developed countries. This epidemic is also fueled by increased survival of preterm babies with variable use of oxygen and a lack of ROP awareness and screening services in resource-limited regions. Improvements in technology and a basic understanding of the disease pathophysiology have changed the way we screen and manage ROP, educate providers and patients, and improve ROP awareness. Advancements in imaging techniques, expansion of telemedicine services, and the potential for artificial intelligence-assisted ROP screening programs have created opportunities to improve ROP care in areas with a shortage of ophthalmologists trained in ROP. To address the gap in provider knowledge regarding ROP, the Global Education Network for Retinopathy of Prematurity (GEN-ROP) created a web-based tele-education training module that can be used to educate all providers involved in ROP, including non-physician ROP screeners. Over the past 50 years, the treatment of severe ROP has evolved from limited treatment modalities to cryotherapy and laser photocoagulation. More recently, there has been growing evidence to support the use of anti-vascular endothelial growth factor (VEGF) agents for the treatment of severe ROP. However, VEGF is known to be important in organogenesis and microvascular maintenance, and given that intravitreal anti-VEGF treatment can result in systemic VEGF suppression over a period of at least 1-12 weeks, there are concerns regarding adverse effects and long-term ocular and systemic developmental consequences of anti-VEGF therapy. Future research in ophthalmology to address the growing burden of ROP should focus on cost-effective fundus imaging devices, implementation of artificial intelligence platforms, updated treatment algorithms with optimal use of anti-VEGF and careful investigation of its long-term effects, and surgical options in advanced ROP. Addressing these unmet needs will aid the global effort against the ROP epidemic and optimize our understanding and treatment of this blinding disease.

Authors+Show Affiliations

Singapore National Eye Centre, Singapore; DUKE NUS Medical School, Singapore.Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan.Department of Ophthalmology & Visual Sciences, University of Illinois at Chicago, Illinois Eye and Ear Infirmary, Chicago, IL, USA.Department of Ophthalmology & Visual Sciences, University of Illinois at Chicago, Illinois Eye and Ear Infirmary, Chicago, IL, USA.Department of Ophthalmology & Visual Sciences, University of Illinois at Chicago, Illinois Eye and Ear Infirmary, Chicago, IL, USA.Division of Newborn Medicine, Weill Cornell Medicine, New York, NY, USA.National Eye Institute, National Institutes of Health, Bethesda, MD, USA.Department of Ophthalmology & Visual Sciences, University of Illinois at Chicago, Illinois Eye and Ear Infirmary, Chicago, IL, USA. Electronic address: rvpchan@uic.edu.Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan. Electronic address: weichi666@gmail.com.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

34763060

Citation

Tsai, Andrew Sh, et al. "Assessment and Management of Retinopathy of Prematurity in the Era of Anti-vascular Endothelial Growth Factor (VEGF)." Progress in Retinal and Eye Research, 2021, p. 101018.
Tsai AS, Chou HD, Ling XC, et al. Assessment and management of retinopathy of prematurity in the era of anti-vascular endothelial growth factor (VEGF). Prog Retin Eye Res. 2021.
Tsai, A. S., Chou, H. D., Ling, X. C., Al-Khaled, T., Valikodath, N., Cole, E., Yap, V. L., Chiang, M. F., Chan, R. V. P., & Wu, W. C. (2021). Assessment and management of retinopathy of prematurity in the era of anti-vascular endothelial growth factor (VEGF). Progress in Retinal and Eye Research, 101018. https://doi.org/10.1016/j.preteyeres.2021.101018
Tsai AS, et al. Assessment and Management of Retinopathy of Prematurity in the Era of Anti-vascular Endothelial Growth Factor (VEGF). Prog Retin Eye Res. 2021 Nov 9;101018. PubMed PMID: 34763060.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Assessment and management of retinopathy of prematurity in the era of anti-vascular endothelial growth factor (VEGF). AU - Tsai,Andrew Sh, AU - Chou,Hung-Da, AU - Ling,Xiao Chun, AU - Al-Khaled,Tala, AU - Valikodath,Nita, AU - Cole,Emily, AU - Yap,Vivien L, AU - Chiang,Michael F, AU - Chan,R V Paul, AU - Wu,Wei-Chi, Y1 - 2021/11/09/ PY - 2020/09/30/received PY - 2021/10/27/revised PY - 2021/10/29/accepted PY - 2021/11/12/pubmed PY - 2021/11/12/medline PY - 2021/11/11/entrez KW - Artificial intelligence KW - Laser photo-coagulation KW - ROP education KW - ROP reactivation KW - ROP screening KW - Retinopathy of prematurity KW - Telemedicine KW - Vascular endothelial growth factor therapy SP - 101018 EP - 101018 JF - Progress in retinal and eye research JO - Prog Retin Eye Res N2 - The incidence of retinopathy of prematurity (ROP) continues to rise due to the improved survival of very low birth weight infants in developed countries. This epidemic is also fueled by increased survival of preterm babies with variable use of oxygen and a lack of ROP awareness and screening services in resource-limited regions. Improvements in technology and a basic understanding of the disease pathophysiology have changed the way we screen and manage ROP, educate providers and patients, and improve ROP awareness. Advancements in imaging techniques, expansion of telemedicine services, and the potential for artificial intelligence-assisted ROP screening programs have created opportunities to improve ROP care in areas with a shortage of ophthalmologists trained in ROP. To address the gap in provider knowledge regarding ROP, the Global Education Network for Retinopathy of Prematurity (GEN-ROP) created a web-based tele-education training module that can be used to educate all providers involved in ROP, including non-physician ROP screeners. Over the past 50 years, the treatment of severe ROP has evolved from limited treatment modalities to cryotherapy and laser photocoagulation. More recently, there has been growing evidence to support the use of anti-vascular endothelial growth factor (VEGF) agents for the treatment of severe ROP. However, VEGF is known to be important in organogenesis and microvascular maintenance, and given that intravitreal anti-VEGF treatment can result in systemic VEGF suppression over a period of at least 1-12 weeks, there are concerns regarding adverse effects and long-term ocular and systemic developmental consequences of anti-VEGF therapy. Future research in ophthalmology to address the growing burden of ROP should focus on cost-effective fundus imaging devices, implementation of artificial intelligence platforms, updated treatment algorithms with optimal use of anti-VEGF and careful investigation of its long-term effects, and surgical options in advanced ROP. Addressing these unmet needs will aid the global effort against the ROP epidemic and optimize our understanding and treatment of this blinding disease. SN - 1873-1635 UR - https://www.unboundmedicine.com/medline/citation/34763060/Assessment_and_management_of_retinopathy_of_prematurity_in_the_era_of_anti-vascular_endothelial_growth_factor_(VEGF). L2 - https://linkinghub.elsevier.com/retrieve/pii/S1350-9462(21)00079-3 DB - PRIME DP - Unbound Medicine ER -
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