Prediction and Treatment of ROP: Emerging Strategies
(The abstract of the April16 presentation @ AAPOS)
Deborah K VanderVeen MD; Ann Hellstrom MD, PhD; Kimberly Drenser MD, PhD;
Lois E.H. Smith MD, PhD
Boston Children’s Hospital, Harvard Medical School, Boston MA USA
Despite the newest treatments, over 500 caes of blindness still occur annually in the US from
ROP. Current research is focusing on ways to predict and prevent the disease, and the
group at Boston Children’s has led groundbreaking research in this regard. Results of their
research will be presented, and attendees will learn ways to integrate this into their local
hospital settings, with particular focus on weight gain and its relation to ROP .
Retinopathy of Prematurity(ROP) is a leading cause of childhood visual impairment and
blindness in developed countries, and is increasingly prevalent in developing countries.
Ablative therapy for Type 1 ROP usually allows favorable outcomes, but less destructive and
preventative treatment strategies would be optimal. We need ways to predict early those
infants who will develop ROP, particularly for locales where ophthalmologists are not readily
available.
Low IGF-1 levels and poor post-natal weight gain are important predictors in ROP
development, and weight surveillance alone may help identify infants at highest risk of severe
ROP development. We developed an algorithm (WINROP) that predicts significant ROP
early (median time to development of ROP, 9 weeks, and treatable ROP, 8 weeks) with very
high specificity and sensitivity. A multicenter trial to evaluate this method is underway, and we
will discuss results to date and discuss expanding the use of this method in more US and
world NICUs. Dietary supplementation has also been a topic of ROP research, and since
composition of parenteral nutrition and breast milk plays an important role in brain and eye
development, recognition of deficiencies with supplementation to normal levels could play an
important role in ROP prevention. VEGF inhibitors for ROP treatment offer promise and will
also be discussed, though current use in the US is limited to compassionate use or as part of
a clinical trial such as BLOCK-ROP.
The panel will discuss recent clinical research in these areas and how this information may
be used in the clinical setting.
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