Expert consensus on the treatment of retinopathy of prematurity_Chinese Journal of Ocular Fundus Diseases

Authors：

 Ophthalmology Group of Pediatrics Society of Chinese Medical Association

Corresponding author: Liang Jianhong, Department of Ophthalmology, Peking University People’s Hospital, Beijing 100044, China, Email:drjianhongliang@sina.com;

Corresponding author：

Keywords：

Retinopathy of prematurity; Treatment norms; Consensus

DOI：

10.3760/cma.j.cn511434-20211119-00647

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Retinopathy of prematurity (ROP) is a retinal angioproliferative disease that occurs in premature and low birth weight infants, and is the most common eye disease that causes blindness and low vision in infants. However, there is no systematic standardized guidance on the overall treatment strategy for ROP. Therefore, in order to standardize the treatment of ROP, the Ophthalmology Group of Pediatrics Society of Chinese Medical Association organized relevant domestic experts to put forward standardized opinions on the treatment of ROP in China after repeated discussion, so as to provide clinicians with reference and application in clinical practice.

Citation： Ophthalmology Group of Pediatrics Society of Chinese Medical Association. Expert consensus on the treatment of retinopathy of prematurity. Chinese Journal of Ocular Fundus Diseases, 2022, 38(1): 10-13. doi: 10.3760/cma.j.cn511434-20211119-00647 Copy

1.	Hellström A, Smith LE, Dammann O. Retinopathy of prematurity[J]. Lancet, 2013, 382(9902): 1445-1457. DOI: 10.1016/S0140-6736(13)60178-6.
2.	Barry GP, Yu Y, Ying GS, et al. Retinal detachment after treatment of retinopathy of prematurity with laser versus intravitreal anti-vascular endothelial growth factor[J]. Ophthalmology, 2021, 128(8): 1188-1196. DOI: 10.1016/j.ophtha.2020.12.028.
3.	中华医学会眼科学分会眼底病学组. 中国早产儿视网膜病变筛查指南(2014年)[J]. 中华眼科杂志, 2014, 50(12): 933-935. DOI: 10.3760/cma.j.issn.0412-4081.2014.12.017.Ophthalmology Group of Chinese Medical Association Ophthalmology Branch. Guidelines for screening of retinopathy of prematurity in China (2014)[J]. Chin J Ophthalmol, 2014, 50(12): 933-935. DOI: 10.3760/cma.j.issn.0412-4081.2014.12.017.
4.	中华医学会. 早产儿治疗用氧和视网膜病变防治指南[J]. 中华眼科杂志, 2005, 41(4): 375-376. DOI: 10.3760/j:issn:0412-4081.2005.04.020.Chinese Medical Association. Guidelines for the treatment of premature infants with oxygen and the prevention and treatment of retinopathy[J]. Chin J Ophthalmol, 2005, 41(4): 375-376. DOI: 10.3760/j:issn:0412-4081.2005.04.020.
5.	VanderVeen DK, Melia M, Yang MB, et al. Anti-vascular endothelial growth factor therapy for primary treatment of type 1 retinopathy of prematurity: a report by The American Academy of Ophthalmology[J]. Ophthalmology, 2017, 124(5): 619-633. DOI: 10.1016/j.ophtha.2016.12.025.
6.	Çömez A, Karaküçük Y, Özmen MC, et al. The results of intravitreal bevacizumab monotherapy for treating aggressive posterior retinopathy of prematurity and type 1 retinopathy of prematurity[J]. Eye (Lond), 2021, 35(12): 3302-3310. DOI: 10.1038/s41433-021-01413-4.
7.	Cheng Y, Zhu X, Linghu D, et al. Comparison of the effectiveness of conbercept and ranibizumab treatment for retinopathy of prematurity[J/OL]. Acta Ophthalmol, 2020, 98(8): e1004-e1008[2020-05-08].https://pubmed.ncbi.nlm.nih.gov/32385940/. DOI: 10.1111/aos.14460.
8.	程湧, 梁建宏, 黎晓新. 康柏西普玻璃体腔注射治疗急进性后极部早产儿视网膜病变的疗效观察[J]. 中华眼底病杂志, 2017, 33(2): 144-147. DOI: 10.3760/cma.j.issn.1005-1015.2017.02.008.Chen Y, Liang JH, Li XX. Intravitreal injection of conbercept for aggressive posterior retinopathy of prematurity[J]. Chin J Ocul Fundus Dis, 2017, 33(2): 144-147. DOI: 10.3760/cma.j.issn.1005-1015.2017.02.008.
9.	许宇, 张琦, 季迅达, 等. 玻璃体腔注射抗血管内皮生长因子单克隆抗体ranibizumab联合激光光凝治疗急进性后部型早产儿视网膜病变的疗效观察[J]. 中华眼底病杂志, 2014, 30(1): 28-32. DOI: 10.3760/cma.j.issn.1005-1015.2014.01.008.Xu Y, Zhang Q, Ji XD, et al. Combination of intravitreal injection of ranibizumab and laser photocoagulation for the treatment of aggressive posterior retinopathy of prematurity[J]. Chin J Ocul Fundus Dis, 2014, 30(1): 28-32. DOI: 10.3760/cma.j.issn.1005-1015.2014.01.008.
10.	Yang CS, Wang AG, Sung CS, et al. Long-term visual outcomes of laser-treated threshold retinopathy of prematurity: a study of refractive status at 7 years[J]. Eye (Lond), 2010, 24(1): 14-20. DOI: 10.1038/eye.2009.63.
11.	Nicoară SD, Cristian C, Irimescu I, et al. Diode laser photocoagulation for retinopathy of prematurity: outcomes afer 7 years of treatment[J]. J Pediatr Ophthalmol Strabismus, 2014, 51(1): 39-45. DOI: 10.3928/01913913-20131112-02.
12.	Chiang MF, Quinn GE, Fielder AR, et al. International classification of retinopathy of prematurity, third edition[J/OL]. Ophthalmology, 2021, 128(10): e51-e68[2021-07-08]. https://pubmed.ncbi.nlm.nih.gov/34247850/. DOI: 10.1016/j.ophtha.2021.05.031.
13.	Mintz-Hittner HA, Geloneck MM, Chuang AZ. Clinical management of recurrent retinopathy of prematurity after intravitreal bevacizumab monotherapy[J]. Ophthalmology, 2016, 123(9): 1845-1855. DOI: 10.1016/j.ophtha.2016.04.028.
14.	Toy BC, Schachar IH, Tan GS, et al. Chronic vascular arrest as a predictor of bevacizumab treatment failure in retinopathy of prematurity[J]. Ophthalmology, 2016, 123(10): 2166-2175. DOI: 10.1016/j.ophtha.2016.06.055.
15.	Martínez-Castellanos MA, González-H León A, Romo-Aguas JC, et al. A proposal of an algorithm for the diagnosis and treatment of recurrence or treatment failure of retinopathy of prematurity after anti-VEGF therapy based on a large case series[J]. Graefe's Arch Clin Exp Ophthalmol, 2020, 258(4): 767-772. DOI: 10.1007/s00417-020-04605-y.
16.	李孝纯, 曹晓光, 黎晓新, 等. 晚期早产儿视网膜病变巩膜外加压手术及玻璃体切割手术疗效观察[J]. 中华眼底病杂志, 2016, 32(5): 505-509. DOI: 10.3760/cma.j.issn.1005-1015.2016.05.011.Li XC, Cao XG, Li XX, et al. Therapeutic effect of segmental scleral buckling and vitreoretinal surgery for stage 4 and 5 retinopathy of prematurity[J]. Chin J Ocul Fundus Dis, 2016, 32(5): 505-509. DOI: 10.3760/cma.j.issn.1005-1015.2016.05.011.
17.	许宇, 朱颖, 李家恺, 等. 4期早产儿视网膜病变玻璃体视网膜手术前玻璃体腔注射抗血管内皮生长因子单克隆抗体bevacizumab的安全性和有效性[J]. 中华眼底病杂志, 2012, 28(1): 11-14. DOI: 10.3760/cma.j.issn.1005-1015.2012.01.004.Xu Y, Zhu Y, Li JK, et al. Safety and efficacy of preoperatively intravitreal injection of bevacizumab for stage 4 retinopathy of prematurity[J]. Chin J Ocul Fundus Dis, 2012, 28(1): 11-14. DOI: 10.3760/cma.j.issn.1005-1015.2012.01.004.
18.	Sen P, Bhende P, Rishi E, et al. Anatomical and visual outcomes in stage 5 retinopathy of prematurity with microincision vitrectomy surgery[J]. Retina, 2021, 41(2): 331-337. DOI: 10.1097/IAE.0000000000002837.
19.	Mintz-Hittner HA, Kennedy KA, Chuang AZ, et al. Efficacy of intravitreal bevacizumab for stage 3+ retinopathy of prematurity[J]. N Engl J Med, 2011, 364(7): 603-615. DOI: 10.1056/NEJMoa1007374.
20.	Nudleman E, Muftuoglu IK, Gaber R, et al. Glaucoma after lens-sparing vitrectomy for advanced retinopathy of prematurity[J]. Ophthalmology, 2018, 125(5): 671-675. DOI: 10.1016/j.ophtha.2017.11.009.
21.	Iwahashi-Shima C, Miki A, Hamasaki T, et al. Intraocular pressure elevation is a delayed-onset complication after successful vitrectomy for stages 4 and 5 retinopathy of prematurity[J]. Retina, 2012, 32(8): 1636-1642. DOI: 10.1097/IAE.0b013e3182551c54.

1. Hellström A, Smith LE, Dammann O. Retinopathy of prematurity[J]. Lancet, 2013, 382(9902): 1445-1457. DOI: 10.1016/S0140-6736(13)60178-6.
2. Barry GP, Yu Y, Ying GS, et al. Retinal detachment after treatment of retinopathy of prematurity with laser versus intravitreal anti-vascular endothelial growth factor[J]. Ophthalmology, 2021, 128(8): 1188-1196. DOI: 10.1016/j.ophtha.2020.12.028.
3. 中华医学会眼科学分会眼底病学组. 中国早产儿视网膜病变筛查指南(2014年)[J]. 中华眼科杂志, 2014, 50(12): 933-935. DOI: 10.3760/cma.j.issn.0412-4081.2014.12.017.Ophthalmology Group of Chinese Medical Association Ophthalmology Branch. Guidelines for screening of retinopathy of prematurity in China (2014)[J]. Chin J Ophthalmol, 2014, 50(12): 933-935. DOI: 10.3760/cma.j.issn.0412-4081.2014.12.017.
4. 中华医学会. 早产儿治疗用氧和视网膜病变防治指南[J]. 中华眼科杂志, 2005, 41(4): 375-376. DOI: 10.3760/j:issn:0412-4081.2005.04.020.Chinese Medical Association. Guidelines for the treatment of premature infants with oxygen and the prevention and treatment of retinopathy[J]. Chin J Ophthalmol, 2005, 41(4): 375-376. DOI: 10.3760/j:issn:0412-4081.2005.04.020.
5. VanderVeen DK, Melia M, Yang MB, et al. Anti-vascular endothelial growth factor therapy for primary treatment of type 1 retinopathy of prematurity: a report by The American Academy of Ophthalmology[J]. Ophthalmology, 2017, 124(5): 619-633. DOI: 10.1016/j.ophtha.2016.12.025.
6. Çömez A, Karaküçük Y, Özmen MC, et al. The results of intravitreal bevacizumab monotherapy for treating aggressive posterior retinopathy of prematurity and type 1 retinopathy of prematurity[J]. Eye (Lond), 2021, 35(12): 3302-3310. DOI: 10.1038/s41433-021-01413-4.
7. Cheng Y, Zhu X, Linghu D, et al. Comparison of the effectiveness of conbercept and ranibizumab treatment for retinopathy of prematurity[J/OL]. Acta Ophthalmol, 2020, 98(8): e1004-e1008[2020-05-08].https://pubmed.ncbi.nlm.nih.gov/32385940/. DOI: 10.1111/aos.14460.
8. 程湧, 梁建宏, 黎晓新. 康柏西普玻璃体腔注射治疗急进性后极部早产儿视网膜病变的疗效观察[J]. 中华眼底病杂志, 2017, 33(2): 144-147. DOI: 10.3760/cma.j.issn.1005-1015.2017.02.008.Chen Y, Liang JH, Li XX. Intravitreal injection of conbercept for aggressive posterior retinopathy of prematurity[J]. Chin J Ocul Fundus Dis, 2017, 33(2): 144-147. DOI: 10.3760/cma.j.issn.1005-1015.2017.02.008.
9. 许宇, 张琦, 季迅达, 等. 玻璃体腔注射抗血管内皮生长因子单克隆抗体ranibizumab联合激光光凝治疗急进性后部型早产儿视网膜病变的疗效观察[J]. 中华眼底病杂志, 2014, 30(1): 28-32. DOI: 10.3760/cma.j.issn.1005-1015.2014.01.008.Xu Y, Zhang Q, Ji XD, et al. Combination of intravitreal injection of ranibizumab and laser photocoagulation for the treatment of aggressive posterior retinopathy of prematurity[J]. Chin J Ocul Fundus Dis, 2014, 30(1): 28-32. DOI: 10.3760/cma.j.issn.1005-1015.2014.01.008.
10. Yang CS, Wang AG, Sung CS, et al. Long-term visual outcomes of laser-treated threshold retinopathy of prematurity: a study of refractive status at 7 years[J]. Eye (Lond), 2010, 24(1): 14-20. DOI: 10.1038/eye.2009.63.
11. Nicoară SD, Cristian C, Irimescu I, et al. Diode laser photocoagulation for retinopathy of prematurity: outcomes afer 7 years of treatment[J]. J Pediatr Ophthalmol Strabismus, 2014, 51(1): 39-45. DOI: 10.3928/01913913-20131112-02.
12. Chiang MF, Quinn GE, Fielder AR, et al. International classification of retinopathy of prematurity, third edition[J/OL]. Ophthalmology, 2021, 128(10): e51-e68[2021-07-08]. https://pubmed.ncbi.nlm.nih.gov/34247850/. DOI: 10.1016/j.ophtha.2021.05.031.
13. Mintz-Hittner HA, Geloneck MM, Chuang AZ. Clinical management of recurrent retinopathy of prematurity after intravitreal bevacizumab monotherapy[J]. Ophthalmology, 2016, 123(9): 1845-1855. DOI: 10.1016/j.ophtha.2016.04.028.
14. Toy BC, Schachar IH, Tan GS, et al. Chronic vascular arrest as a predictor of bevacizumab treatment failure in retinopathy of prematurity[J]. Ophthalmology, 2016, 123(10): 2166-2175. DOI: 10.1016/j.ophtha.2016.06.055.
15. Martínez-Castellanos MA, González-H León A, Romo-Aguas JC, et al. A proposal of an algorithm for the diagnosis and treatment of recurrence or treatment failure of retinopathy of prematurity after anti-VEGF therapy based on a large case series[J]. Graefe's Arch Clin Exp Ophthalmol, 2020, 258(4): 767-772. DOI: 10.1007/s00417-020-04605-y.
16. 李孝纯, 曹晓光, 黎晓新, 等. 晚期早产儿视网膜病变巩膜外加压手术及玻璃体切割手术疗效观察[J]. 中华眼底病杂志, 2016, 32(5): 505-509. DOI: 10.3760/cma.j.issn.1005-1015.2016.05.011.Li XC, Cao XG, Li XX, et al. Therapeutic effect of segmental scleral buckling and vitreoretinal surgery for stage 4 and 5 retinopathy of prematurity[J]. Chin J Ocul Fundus Dis, 2016, 32(5): 505-509. DOI: 10.3760/cma.j.issn.1005-1015.2016.05.011.
17. 许宇, 朱颖, 李家恺, 等. 4期早产儿视网膜病变玻璃体视网膜手术前玻璃体腔注射抗血管内皮生长因子单克隆抗体bevacizumab的安全性和有效性[J]. 中华眼底病杂志, 2012, 28(1): 11-14. DOI: 10.3760/cma.j.issn.1005-1015.2012.01.004.Xu Y, Zhu Y, Li JK, et al. Safety and efficacy of preoperatively intravitreal injection of bevacizumab for stage 4 retinopathy of prematurity[J]. Chin J Ocul Fundus Dis, 2012, 28(1): 11-14. DOI: 10.3760/cma.j.issn.1005-1015.2012.01.004.
18. Sen P, Bhende P, Rishi E, et al. Anatomical and visual outcomes in stage 5 retinopathy of prematurity with microincision vitrectomy surgery[J]. Retina, 2021, 41(2): 331-337. DOI: 10.1097/IAE.0000000000002837.
19. Mintz-Hittner HA, Kennedy KA, Chuang AZ, et al. Efficacy of intravitreal bevacizumab for stage 3+ retinopathy of prematurity[J]. N Engl J Med, 2011, 364(7): 603-615. DOI: 10.1056/NEJMoa1007374.
20. Nudleman E, Muftuoglu IK, Gaber R, et al. Glaucoma after lens-sparing vitrectomy for advanced retinopathy of prematurity[J]. Ophthalmology, 2018, 125(5): 671-675. DOI: 10.1016/j.ophtha.2017.11.009.
21. Iwahashi-Shima C, Miki A, Hamasaki T, et al. Intraocular pressure elevation is a delayed-onset complication after successful vitrectomy for stages 4 and 5 retinopathy of prematurity[J]. Retina, 2012, 32(8): 1636-1642. DOI: 10.1097/IAE.0b013e3182551c54.

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