Retinopathy of prematurity: a review of risk factors and their clinical significance

Surv Ophthalmol. 2018 Sep-Oct;63(5):618-637. doi: 10.1016/j.survophthal.2018.04.002. Epub 2018 Apr 19.


Retinopathy of prematurity (ROP) is a retinal vasoproliferative disease that affects premature infants. Despite improvements in neonatal care and management guidelines, ROP remains a leading cause of childhood blindness worldwide. Current screening guidelines are primarily based on two risk factors: birth weight and gestational age; however, many investigators have suggested other risk factors, including maternal factors, prenatal and perinatal factors, demographics, medical interventions, comorbidities of prematurity, nutrition, and genetic factors. We review the existing literature addressing various possible ROP risk factors. Although there have been contradictory reports, and the risk may vary between different populations, understanding ROP risk factors is essential to develop predictive models, to gain insights into pathophysiology of retinal vascular diseases and diseases of prematurity, and to determine future directions in management of and research in ROP.

Keywords: pediatric ophthalmology; preterm infant; retina; retinopathy of prematurity; risk factor; risk model.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Review

MeSH terms

  • Birth Weight
  • Diet
  • Female
  • Gestational Age
  • Humans
  • Infant, Premature
  • Oxygen / adverse effects
  • Pregnancy
  • Pregnancy Complications
  • Retinopathy of Prematurity / etiology*
  • Risk Factors
  • Smoking / adverse effects


  • Oxygen