• Strategies for Prevention of ROP

    What’s the best way to treat ROP? Prevent it, according to Lois Smith, MD, PhD, during Pediatric Subspecialty Day.

    Insulin-like growth factor I (IGF-I). According to Dr. Smith, fetal IGF-I levels increase during the third trimester; thus, premature babies do not have adequate amounts. Low IGF-I prevents VEGF-induced angiogenesis and leads to loss of existing vessels. Phase 1 pharmacokinetic studies showed that IGF-I did not induce hypoglycemia and had a good safety profile. Phase 2 clinical trials are currently under way.

    Omega-3 polyunsaturated fatty acids (PUFAs). According to Dr. Smith, there is a massive transfer of omega-3 PUFAs from mother to fetus during the third trimester, which is lost in prematurity. Omega-3 PUFA can reduce both phase 1 and phase 2 ROP in animal models and human infants. Dr. Smith suggests that increasing omega-3 PUFA intake in premature babies may decrease risk of ROP as well as reduce the need for laser treatment.

    Oxygen. Control of oxygen tension is vital, but reaching a delicate equilibrium can be tricky, as too little oxygen can lead to death and brain damage, and too much can lead to ROP. Fluctuating oxygen concentrations or intermittent hypoxia could lead to more severe ROP.—Keng Jin Lee

    Financial disclosures. Dr. Smith—Shire: C.

    Disclosure key. C = Consultant/Advisor; E = Employee; L = Speakers bureau; O = Equity owner; P = Patents/Royalty; S = Grant support.