title: The association between systemic vascular endothelial growth factor and retinopathy of prematurity in premature infants: a systematic review.
abstract: Retinopathy of prematurity (ROP), a vasoproliferative disorder exclusive to premature infants is an important cause of childhood blindness. The number of premature infants surviving with this condition is expected to increase globally. Animal models of oxygen-induced retinopathy studies have shown vascular endothelial growth factor (VEGF) to be a key player in the pathogenesis of ROP. This has led to increased use of VEGF antagonist as an alternative treatment for ROP. The purpose of this systematic review is to determine the association between VEGF and ROP in human newborn. The literature review identified 12 studies to date which fulfilled the search criteria. Investigators used cord blood, serum, plasma and tissue samples to investigate the association between ROP and VEGF. Studies that measured VEGF in cord blood found mixed results, with low VEGF (at birth) associated with ROP in one study and no difference noted in two others. Mixed results were also seen in studies determining VEGF in postnatal venous samples. Four studies showed no difference in VEGF level between premature infants with and without ROP, one study showed an increased VEGF level in premature infants with ROP and another study found serum VEGF to be low in premature infants with ROP. The most recent study demonstrated an initial increase in serum VEGF followed by a decline at the time of treatment. These contradictory results indicate that we are yet to fully understand the role of VEGF in human premature infants and question the rationale of treating ROP with anti-VEGF. Anti-VEGF therapy results in systemic effect on serum VEGF levels for up to 2 months and this could have an effect on neurodevelopmental outcome. The effect of this on other developing organs is currently unknown. More studies are required to determine the mechanistic relationships between systemic VEGF and ROP in premature infants.
authors.affiliation: Department of Neonatology, The Townsville Hospital, Douglas, Queensland, Australia.|Mothers and Babies Research Centre, Hunter Medical Research Institute, John Hunter Hospital, The University of Newcastle, Callaghan, New South Wales, Australia.|College of Public Health, Medical and Veterinary Sciences, The James Cook University, Townsville, Queensland, Australia.
authors.forename: Yogavijayan
authors.initials: Y
authors.lastname: Kandasamy
authors.affiliation: Department of Optometry and Vision Science, The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Leo
authors.initials: L
authors.lastname: Hartley
authors.affiliation: College of Public Health, Medical and Veterinary Sciences, The James Cook University, Townsville, Queensland, Australia.
authors.forename: Donna
authors.initials: D
authors.lastname: Rudd
authors.affiliation: Mothers and Babies Research Centre, Hunter Medical Research Institute, John Hunter Hospital, The University of Newcastle, Callaghan, New South Wales, Australia.
authors.forename: Roger
authors.initials: R
authors.lastname: Smith
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D000068258:Bevacizumab / Q000627:therapeutic use; D005312:Fetal Blood / Q000737:chemistry; D006801:Humans; D007231:Infant, Newborn; D010949:Plasma / Q000737:chemistry; D012178:Retinopathy of Prematurity / Q000097:blood* / Q000188:drug therapy; D044967:Serum / Q000737:chemistry; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*
chemical_list: D020533:Angiogenesis Inhibitors; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab
keywords: Child health (paediatrics); Retina; Treatment Medical