Questions and Answers
The aberrant growth of blood vessels into the vitreous is caused by over-activation of the ______ receptor 2 signaling.
VEGF
Targeting different cells in the retina aims to inhibit aberrant ______ and promote physiologic retinal vascular development.
angiogenesis
Toxicity can result from both broad and targeted inhibition of ______ bioactivity.
VEGF
VEGF plays a crucial role in ______ during retinal development.
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Future translational treatments for ROP include considerations for targeted inhibition of ______ signaling.
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Retinopathy of prematurity (ROP) was originally described by ______ in 1942.
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The most severe form of ROP is classified as stage ______.
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The hypothesis of ROP has been revised to include a delay in physiologic retinal vascular ______.
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The Schepens/Pomerantzeff binocular indirect ______ had not been widely adopted to examine the peripheral retina.
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Earlier stages of ROP were not well described due to a lack of proper examination tools, leading to some ______-induced vasoattenuation in phase 1.
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Study Notes
Causes and Mechanisms of ROP
- Retinopathy of prematurity (ROP) is associated with high oxygen exposure at birth, leading to vaso-obliteration of fragile retinal capillaries.
- Newborn animals exposed to similar conditions as premature infants show neovascularization in the vitreous (intravitreal neovascularization or IVNV).
- Both the phenotype of ROP and prevalence vary globally based on prenatal care resources and oxygen regulation practices.
Clinical Observations and Treatment Implications
- Preterm infants with larger birth weights are now showing severe ROP in regions with suboptimal nutrition and neonatal resources.
- Heritable factors contribute to ROP, but candidate gene studies face limitations due to small sample sizes and phenotypic variability.
- In the United States, infants with severe ROP tend to be younger and smaller compared to those in resource-limited countries.
VEGF and Treatment Strategies
- Targeted knockdown of VEGF164 was shown to significantly reduce IVNV compared to controls, with implications for safety and efficacy.
- Studies indicate that targeting Müller cell VEGF164 might be safer than targeting VEGFA, which resulted in increased cell death and thinner outer nuclear layers.
- Monitoring body weight gain, vascular coverage, and recurrence of IVNV are crucial safety measures in treatment.
Efficacy of Bevacizumab
- The usage of intravitreal bevacizumab for treating Stage 3+ ROP alters angiogenic pathways but may also affect the overall biochemistry of ROP, leading to late treatment failures.
- Future treatments should consider targeted inhibition of specific VEGF signaling rather than broad anti-VEGF interventions.
Historical Context and Advances in Understanding ROP
- ROP was first described in 1942 as “retrolental fibroplasia,” and knowledge has evolved significantly since then.
- A revised hypothesis indicates a delay in normal retinal vascular development and subsequent hyperoxia-induced vasoattenuation during the early phase.
Future Directions
- Ongoing research aims to investigate varied treatment strategies to address aberrant angiogenesis and promote physiological retinal vascular development.
- The role of neuroprotection via VEGF in retinal development necessitates further exploration within translational treatment frameworks.
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Description
This quiz examines the causes and effects of Retinopathy of Prematurity (ROP) by analyzing studies conducted on newborn animals exposed to specific conditions. Explore how these studies inform our understanding of vascularization and neovascularization in the retinas of premature infants.
