Retinopathy of prematurity: Moving beyond oxygen

Retinopathy of prematurity (ROP) is a vision-threatening disease among very preterm newborns in high-income countries and also in gestationally older newborns in low resource settings. The main classic risk factor and purported causal culprit is exogenous oxygen, which regulates angiogenic growth factors in the two phases of the disease. Along these lines, the vast majority of animal studies use oxygen-induced retinopathy models, with very limited data coming from non-oxygen models. We make the case in favor of alternative etiological paradigms and call for more models that employ infection and inflammation-associated exposures. We support our argument by reference to recent experimental and clinical data.