Anti-angiogenic therapy in the management of retinopathy of prematurity

Dev Ophthalmol. 2009:44:89-97. doi: 10.1159/000223949. Epub 2009 Jun 3.

Abstract

Retinopathy of prematurity (ROP) is a vitreoretinal abnormality that significantly affects premature babies with low birth rates. Despite improved screening and management of these infants, a subset will progress to retinal detachment and permanent visual impairment. Current treatment consists of peripheral laser ablation and subsequent surgical intervention if a detachment occurs. We sought to evaluate the vitreous biochemistry of eyes that progress despite appropriate laser intervention. Additionally, a limited trial of an anti-VEGF (vascular endothelial growth factor) therapy was used in one eye of infants with persistent Plus disease and neovascularization. The anti-VEGF treatment successfully decreases abnormal angiogenesis but does not decrease the proliferative changes associated with retinal detachment. Biochemical analysis of the vitreous of stage 4 ROP eyes shows significantly elevated VEGF and transforming growth factor (TGF-beta) concentrations, and normal levels of other angiogenic factors.

Publication types

  • Review

MeSH terms

  • Angiogenesis Inhibitors / administration & dosage
  • Angiogenesis Inhibitors / therapeutic use*
  • Humans
  • Infant, Newborn
  • Laser Coagulation / methods*
  • Prognosis
  • Retinal Neovascularization / etiology
  • Retinal Neovascularization / pathology
  • Retinal Neovascularization / prevention & control
  • Retinopathy of Prematurity / drug therapy*
  • Retinopathy of Prematurity / metabolism
  • Retinopathy of Prematurity / pathology
  • Transforming Growth Factor beta / drug effects
  • Transforming Growth Factor beta / metabolism
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors*

Substances

  • Angiogenesis Inhibitors
  • Transforming Growth Factor beta
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A