caa a22 4500 465794106 CHVBK 20180323112033.0 cr unu---uuuuu 170327e19900301xx s 000 0 eng 10.1007/BF02482610 doi (NATIONALLICENCE)springer-10.1007/BF02482610 The pathogenesis of retinopathy of prematurity as it relates to surgical treatment [Elektronische Daten] [Frank Kretzer, Rekha Mehta, Evelyn Brown, Helen Mintz-Hittner] Our current surgical treatment for threshold retinopathy of prematurity (ROP) is based upon three concepts which emerged from morphologic and biochemical study of 250 pairs of whole eye donations obtained over a ten year period. 1) Spindle cells normally migrate and canalize to form inner retinal vessels, but when stressed, spindle cells secrete angiogenic factors. The clinical implication is that transretinal cryotherapy to the avascular retina is efficacious because it obliterates spindle cells. The number and timing of cryosessions are determined by the migration and kinetics of spindle cells. 2) Myofibroblasts originate from the shunt, are the major cellular component of extraretinal fibrovascular proliferation (EFP), and contract to produce retinal distortion and detachment. The clinical implication is that a second transretinal cryotherapy session should obliterate the shunt and the EFP, and should eliminate the source of retinal traction. 3) Anterior ocular growth occurs exponentially during the period when ROP develops and is treated. The clinical implication is that a prophylactic scleral buckle supports the fixed surface area of the developing retina while the choroid and sclera enlarge anteriorly. Retinal distortion produces misaligned photoreceptors, and retinal detachment results in rapid retinal death. Kluwer Academic Publishers, 1990 retinopathy of prematurity nationallicence cryotherapy nationallicence myofibroblasts (tractional forces) nationallicence ocular growth nationallicence scleral buckling nationallicence spindle cells (angiogenic stimulation) nationallicence Kretzer Frank Cullen Eye Institute, Baylor College of Medicine, 77030, Houston, TX, USA aut Mehta Rekha Cullen Eye Institute, Baylor College of Medicine, 77030, Houston, TX, USA aut Brown Evelyn Cullen Eye Institute, Baylor College of Medicine, 77030, Houston, TX, USA aut Mintz-Hittner Helen Cullen Eye Institute, Baylor College of Medicine, 77030, Houston, TX, USA aut Documenta Ophthalmologica Kluwer Academic Publishers 74/3(1990-03-01), 205-211 0012-4486 74:3<205 1990 74 10633 https://doi.org/10.1007/BF02482610 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF02482610 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kretzer Frank Cullen Eye Institute, Baylor College of Medicine, 77030, Houston, TX, USA aut NATIONALLICENCE 700 1- Mehta Rekha Cullen Eye Institute, Baylor College of Medicine, 77030, Houston, TX, USA aut NATIONALLICENCE 700 1- Brown Evelyn Cullen Eye Institute, Baylor College of Medicine, 77030, Houston, TX, USA aut NATIONALLICENCE 700 1- Mintz-Hittner Helen Cullen Eye Institute, Baylor College of Medicine, 77030, Houston, TX, USA aut NATIONALLICENCE 773 0- Documenta Ophthalmologica Kluwer Academic Publishers 74/3(1990-03-01), 205-211 0012-4486 74:3<205 1990 74 10633 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer