From the Research
The Vermont Oxford Network (VON) recommends comprehensive screening and management protocols for retinopathy of prematurity (ROP) in premature infants, with treatment options including laser photocoagulation or intravitreal anti-VEGF agents like bevacizumab, as supported by the most recent study from 2021 1. The key aspects of ROP management include:
- Screening for infants born at less than 30 weeks gestational age or with birth weight less than 1500 grams by an ophthalmologist experienced in neonatal care
- Initial screening at 31 weeks postmenstrual age or 4 weeks chronological age, whichever is later
- Follow-up examinations every 1-3 weeks until retinal vascularization is complete or ROP has regressed
- Treatment for type 1 ROP within 72 hours of diagnosis Some of the key findings from recent studies include:
- A study from 2019 2 found that low-dose anti-VEGF treatments, such as 0.16 mg bevacizumab, can be effective in treating ROP
- A study from 2018 3 compared the outcomes of patients with type I ROP treated with either intravitreal bevacizumab or retinal laser photocoagulation, and found that both treatments were effective, but with some differences in refractive errors and complications
- The most recent study from 2021 1 compared the 5-year safety and efficacy of laser photocoagulation and intravitreal bevacizumab injection in ROP, and found that IVB was not inferior to laser in neurodevelopment or visual outcome, and was superior in refractive error. Prevention strategies are also crucial, including:
- Careful oxygen management targeting saturation levels of 90-95%
- Minimizing fluctuations in oxygen levels
- Optimizing nutrition with breast milk when possible Overall, ROP screening and management are critical to prevent childhood blindness, and timely intervention can significantly reduce the risk of vision loss in premature infants, as supported by the evidence from 2, 3, 1.