Retinopathy of prematurity is one of the leading causes of childhood blindness and emanates from abnormal retinal vascularization during development. Management of the disease is bound by very specific screening protocols to which visual outcomes are believed to be exquisitely sensitive. Although current treatments generally revolve around laser or cryotherapy destruction of pathologic retina in an effort to reduce the angiogenic drive toward worsening disease, new pharmacologic strategies are at various stages of clinical development. We here review the pathology of retinopathy of prematurity and its relationship to such new advances in treatment. Specifically, the use of laser photoablation, cryoablation, anti–vascular endothelial growth factor therapy, insulin growth factor-1, long-chain polyunsaturated fatty acids and propranolol is reviewed in the context of both clinical trial and animal model data.

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