Retinopathy of prematurity: Current status, treatment, prevention, and future directions from the perspective of developing countries

Retinopathy of prematurity (ROP) is the leading cause of preventable blindness in pediatric population living in developing countries. Increasing survival rates of premature patients have been globally improving during the last years and this is the main reason of blindness rate escalation secondary to ROP. The advent of intravitreal injections of antiangiogenic agents in therapeutic ophthalmological arsenal has provided an easier and faster way to prevent retinal detachment in this extremely fragile population. In the nearest future, we will witness, how medical science will provide enough scientific evidence to treat properly these patients with the lowest and safest dose of anti-vascular endothelial growth factor intraocular injections with the fewer systemic side effects. Meanwhile, transpupillary retinal laser photocoagulation of the avascular retina will remain the “gold standard” for ROP treatment, and for sure, this option could also provide a feasible alternative in the future for those cases, where intravitreal injections will fail. Neonatologists and ophthalmologists should keep on working together to fight against children's blindness, synchronizing retinal examinations timing criteria by adequate eye screening. Low- and middle-income countries' health governmental care suppliers should organize suitable programs for providing adequate neonatal care for premature patients and preventing, detecting, and treating effectively ROP. Training and teaching ROP screening and treatment programs are also a responsibility to be taken by local health care authorities and university residency courses for young ophthalmologists. This review describes the situation, state-of-the-art treatment, blindness prevention options from developing countries' viewpoints.