With increased survival of very premature infants in the United States and across the world, retinopathy of prematurity (ROP) remains a leading cause of preventable childhood visual impairment and blindness. Premature birth requires that retinal maturation take place in a physiologically abnormal environment, leading to retinal injury and dysregulated growth and development. Although the pathophysiology of ROP is understood to involve exposure to extrauterine hypoxia and hyperoxia, multiple international studies have failed to identify the optimal approach to preventing ROP. Clinical efforts therefore center on optimizing screening and identification of ROP and on improving ophthalmologic interventions to modify the course of vision-threatening disease.

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