[Pathogenesis of retinopathy of prematurity].
Retinopathy of prematurity (ROP) is a vascular disease of the eye unique to preterm infants. The distinctive feature of ROP is that is an illness of the still-maturing organism. Thus, an understanding of the normal fetal development of the retina is fundamental to understanding the pathogenesis of ROP. Animal models of ROP differ in important attributes, a fact that is important for interpretation of results. However, all models have in common the finding that ROP is a biphasic disease. In the first phase, relative hyperoxia results in vaso-obliteration and vessel loss. The second phase is characterized by hypoxia-induced neovascularization resulting in retinal detachment and blindness. Oxygen-dependent vascular endothelial growth factor (VEGF) and oxygen-independent insulin-like growth factor (IGF-1) have been identified as important factors in the pathogenesis of ROP. These findings suggest new therapeutic approaches. Substitution of IGF-1 during the first phase of the disease may help prevent vessel loss, and administration of anti-angiogenic substances during the second phase may prevent pathological neovascularization.
Heckmann
M
M
Abt. für Allgemeine Pädiatrie und Neonatologie, Zentrum für Kinderheilkunde und Jugendmedizin, Justus-Liebig-Universität, Feulgenstrasse 12, 35385 Giessen. Matthias.Heckmann@paediat.med.uni-giessen.de
D000818:Animals; D004195:Disease Models, Animal; D005865:Gestational Age; D006801:Humans; D018496:Hyperoxia / Q000150:complications / Q000473:pathology; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D010100:Oxygen / Q000097:blood; D011379:Prognosis; D012163:Retinal Detachment / Q000209:etiology / Q000473:pathology; D015861:Retinal Neovascularization / Q000209:etiology / Q000473:pathology; D012171:Retinal Vessels / Q000473:pathology; D012178:Retinopathy of Prematurity / Q000209:etiology* / Q000473:pathology; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism
D042461:Vascular Endothelial Growth Factor A; D007334:Insulin-Like Growth Factor I; D010100:Oxygen