Pathophysiology of Retinopathy of Prematurity

Retinopathy of prematurity (ROP), an ocular disease characterized by onset of vascular abnormalities in the developing retina, is the major\udcause of visual impairment and blindness in premature neonates. ROP is a complex multifactorial disease that occurs with microvascular\uddegeneration followed by neovascularization which passing through different stages can progress to retinal detachment. Currently used\udablative therapies like cryocoagulation and laser photocoagulation for proliferative ROP have limitations, and patients can still have long-term\udcomplications despite a successful treatment. Based on the knowledge regarding ROP pathophysiology, new treatment modalities are being\uddeveloped. First results of intravitreal anti-VEGF therapy using bevacizumab are promising. Furthermore, besides intravitreal anti-VEGF\udtherapy, systemic therapy with mediators like insulin-like growth factor (IGF-1) and/or ω3-fatty acids outlines the pharmacological approach\udto treatment of ROP. One of the most destructive manifestations of ROP is preretinal neovascularization. As we continue to decipher the\udunderlying pathophysiological cellular mechanisms governing proliferative retinopathy, fostering normal retinal revascularization will open\udnew therapeutic possibilities. All efforts should be focused on developing preventive strategies for ROP in order to avoid the need for\udnondestructive therapy modalities. (Turk J Ophthalmol 2012; 42: Supplement 63-7