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Clin Exp OphthalmolSeptember 20251 citations

Review of Retinopathy of Prematurity Management in the Anti-VEGF Era: Evolving Global Paradigms, Persistent Challenges and Our AI-Assisted Future.

Marra Kyle V, Chen Jimmy S, Nudleman Eric, Robbins Shira L


AI Summary

Anti-VEGF revolutionized ROP treatment, but challenges like persistent avascular retina and long-term complications remain. AI and telemedicine offer hope for improved screening and outcomes globally.

Abstract

Retinopathy of prematurity (ROP) remains a major cause of preventable blindness in premature infants worldwide, with increasing incidence due to advancements in neonatal care. Management of ROP has been revolutionised by anti-vascular endothelial growth factor (anti-VEGF) treatments. Pivotal clinical trials have demonstrated the efficacy of anti-VEGF in the management of Type 1 ROP, while investigation of safety and long-term effects is ongoing. However, infants with ROP often have persistent avascular retina (PAR) despite treatment and require lifelong monitoring for myopia, glaucoma, amblyopia, strabismus, significant refractive error, retinal tears and detachment and adult reactivation of ROP. Alternative therapeutics, including beta-blockers, polyunsaturated fatty acids and vitamin A, remain under investigation. Alongside therapeutic advancements, artificial intelligence (AI) and telemedicine programmes have the potential to expand screening accessibility, particularly in underserved regions, and improve inter-observer variability, though challenges in implementation remain. Together, advanced therapeutics and AI-enhanced screening hold promise for improving outcomes and reducing ROP-related blindness globally.


MeSH Terms

HumansRetinopathy of PrematurityVascular Endothelial Growth Factor AAngiogenesis InhibitorsInfant, NewbornArtificial IntelligenceDisease ManagementInfant, Premature

Key Concepts5

Pivotal clinical trials have demonstrated the efficacy of anti-vascular endothelial growth factor (anti-VEGF) in the management of Type 1 ROP.

TreatmentReviewReview of pivotal clinical trialsn=Not applicableCh28

Infants with ROP often have persistent avascular retina (PAR) despite treatment and require lifelong monitoring for myopia, glaucoma, amblyopia, strabismus, significant refractive error, retinal tears and detachment and adult reactivation of ROP.

PrognosisReviewn=Not applicable

Retinopathy of prematurity (ROP) remains a major cause of preventable blindness in premature infants worldwide, with increasing incidence due to advancements in neonatal care.

EpidemiologyReviewn=Not applicableCh10

Alternative therapeutics for ROP, including beta-blockers, polyunsaturated fatty acids and vitamin A, remain under investigation.

TreatmentReviewReview of investigational therapiesn=Not applicableCh28

Artificial intelligence (AI) and telemedicine programmes have the potential to expand screening accessibility for ROP, particularly in underserved regions, and improve inter-observer variability.

MethodologyReviewReview of technological advancementsn=Not applicable

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