Retinopathy of Prematurity Medication

Updated: Feb 10, 2023
  • Author: Siva Subramanian, MD, FAAP; Chief Editor: Santina A Zanelli, MD  more...
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Medication Summary

Intravitreal aflibercept (Eylea), a VEGF inhibitor, gained FDA approval in February 2023 as the first pharmacologic treatment for preterm infants with retinopathy of prematurity (ROP).

If a patient has prethreshold ROP, some centers try to maintain normal serum levels of vitamin E. Vitamin E use was evaluated in a meta-analysis, and levels should be maintained within the reference range in patients at high risk for severe ROP.


Ophthalmics, VEGF Inhibitors

Class Summary

Vascular endothelial growth factor-A (VEGF-A) and placental growth factor (PlGF) are members of the VEGF family of angiogenic factors that can act as mitogenic, chemotactic, and vascular permeability factors for endothelial cells.  

VEGF receptor 1 (VEGFR-1) and VEGFR-2, present on the surface of endothelial cells. PlGF binds only to VEGFR-1, which is also present on the surface of leukocytes. 

Activation of these receptors by VEGF-A can result in neovascularization and vascular permeability.

Aflibercept intravitreal (Eylea)

Aflibercept acts as a soluble decoy receptor that binds VEGF-A and PlGF, and thereby can inhibit the binding and activation of these related VEGF receptors. It is indicated for prematurity of retinopathy.