Zhang Hong-Bing, Wang Xiao-Dong, Xu Kun, Li Xiao-Gang
Eye Institute of Shaanxi Province; Xi'an First Hospital, Xi'an 710002, Shaanxi Province, China.
Department of Internal Medicine; Department of Biochemistry and Molecular Biology, University of Kansas Medical Center, Kansas City, KS 66160, USA.
Int J Ophthalmol. 2018 May 18;11(5):858-873. doi: 10.18240/ijo.2018.05.24. eCollection 2018.
Retinopathy of prematurity (ROP) is a retinal vascular disorder frequently found in premature infants. Different therapeutic strategies have been developed to treat ROP. However, there are still many children with ROP suffering by severe limitations in vision or even blindness. Recently, ROP has been suggested to be caused by abnormal development of the retinal vasculature, but not simply resulted by retinal neovascularization which takes about 4 to 6wk after birth in premature infants. Thus, instead of focusing on how to reduce retinal neovascularization, understanding the pathological changes and mechanisms that occur prior to retinal neovascularization is meaningful, which may lead to identify novel target(s) for the development of novel strategy to promote the healthy growth of retinal blood vessels rather than passively waiting for the appearance of retinal neovascularization and removing it by force. In this review, we discussed recent studies about, 1) the pathogenesis prior to retinal neovascularization in oxygen-induced retinopathy (OIR; a ROP in animal model) and in premature infants with ROP; 2) the preclinical and clinical research on preventive treatment of early OIR and ROP. We will not only highlight the importance of the mechanisms and signalling pathways in regulating early stage of ROP but also will provide guidance for actively exploring novel mechanisms and discovering novel treatments for early phase OIR and ROP prior to retinal neovascularization in the future.
早产儿视网膜病变(ROP)是一种常见于早产儿的视网膜血管疾病。目前已开发出不同的治疗策略来治疗ROP。然而,仍有许多ROP患儿存在严重的视力受限甚至失明问题。最近,有人提出ROP是由视网膜血管系统异常发育引起的,而不仅仅是由早产儿出生后约4至6周出现的视网膜新生血管化导致的。因此,了解视网膜新生血管化之前发生的病理变化和机制,而不是专注于如何减少视网膜新生血管化,是有意义的,这可能有助于确定新的靶点,以开发促进视网膜血管健康生长的新策略,而不是被动等待视网膜新生血管化的出现并强行消除它。在这篇综述中,我们讨论了最近的研究,1)氧诱导性视网膜病变(OIR;ROP的动物模型)和ROP早产儿视网膜新生血管化之前的发病机制;2)早期OIR和ROP预防治疗的临床前和临床研究。我们不仅将强调机制和信号通路在调节ROP早期阶段的重要性,还将为未来积极探索新机制和发现视网膜新生血管化之前早期OIR和ROP的新治疗方法提供指导。