Retinopathy of prematurity (ROP) is a vasoproliferative disorder with an imminent risk of blindness, in cases where early diagnosis and treatment are not performed. The doctors’ constant motivation to give these fragile beings a chance at life with optimal visual acuity has never stopped, since Terry first described this condition. Thus, throughout time, several specific advancements have been made in the management of ROP. Apart from the most known risk factors, this narrative review brings to light the latest research about new potential risk factors, such as: proteinuria, insulin-like growth factor 1 (IGF-1) and blood transfusions. Digital imaging has revolutionized the management of retinal pathologies, and it is more and more used in identifying and staging ROP, particularly in the disadvantaged regions by the means of telescreening. Moreover, optical coherence tomography (OCT) and automated diagnostic tools based on deep learning offer new perspectives on the ROP diagnosis. The new therapeutical trend based on the use of anti-VEGF agents is increasingly used in the treatment of ROP patients, and recent research sustains the theory according to which these agents do not interfere with the neurodevelopment of premature babies.

Having a classical role in the regulation of calcium homeostasis in skeletal system, vitamin D has also been recognized as being involved in the activity of the immune system, as well as in the pathology of the visual analyzer. Thus, regarding the function of vitamin D in the eye, this is supported by the identification of vitamin D receptors (VDR) in several structures of the eyeball, such as corneal epithelial and endothelial cells, ciliary body and retinal cells. One of the ophthalmological pathologies in which vitamin D plays an important role is diabetic retinopathy, both through its effects on the immune system (reduction of the pro-inflammatory cytokines - IL-1, IL-6, IL-012, TNF alpha, and stimulation of anti-inflammatory cytokines IL-10), as well as by reducing the level of vascular endothelial growth factor (VEGF) and thus inhibiting retinal neovascularization. Vitamin D demonstrates a protective role on the development and progression of diabetic retinopathy by reducing blood sugar, hypertension and atherosclerosis, but randomized studies are still needed to establish the direct causal relationship between the development of diabetic retinopathy and vitamin D levels.

Background and Objectives: Retinopathy of prematurity (ROP) remains a leading cause of preventable childhood blindness, with its severity influenced by a complex interaction between nutritional status, metabolic maturation, and systemic vulnerability. This study aimed to evaluate whether early nutritional patterns and serum metabolic parameters, including hepatic and renal biomarkers, are associated with ROP severity and whether they may serve as potential predictors of disease progression. Materials and Methods: We conducted a retrospective study on 140 preterm infants, totaling 280 eyes, admitted between 2021 and 2024 in two neonatal intensive care units (NICU). Each eye was analyzed independently according to International Classification of Retinopathy of Prematurity (ICROP) criteria. Data on the timing of enteral feeding, duration and type of nutrition, and serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total protein, blood glucose, urea and creatinine were collected throughout the first 28 days of life. Statistical analysis included Kruskal–Wallis and Chi-square tests, with a significance threshold of p < 0.05. Results: ROP was identified in 53.57% of cases. Enteral feeding began earlier in infants without ROP, whereas delayed initiation and prolonged parenteral nutrition were associated with more advanced stages. Natural feeding decreased with increasing severity and was absent in aggressive retinopathy of prematurity (A-ROP). Severe disease stages showed higher AST, ALT, urea and creatinine levels, along with lower early total protein values. Glycemic instability was observed more frequently in stage 2 and stage 3. Conclusions: Early nutritional support, especially early enteral feeding and natural feeding, appears protective against ROP progression. Hepatic, renal and glycemic metabolic changes are closely correlated with disease severity, indicating that metabolic balance reflects overall vulnerability in preterm infants. Incorporating nutritional and metabolic assessment into routine screening may enhance early risk identification and optimize clinical monitoring.

To analyze the relationship between lipoproteins such as total cholesterol, LDL-c, TG, and retinal parameters in patients with DM type II without signs of DR. A case-control study, consisting of 2 groups. A group of 64 patients with type II diabetes without signs of DR and a control group of 24 healthy subjects. Patients with DM type I, those who showed signs of DR, and those who had associated other eye diseases were excluded. The patients of the two studied groups had a similar average age: 65 years in the DM type II group and 64 years in the control group. In the group with DM, the average CRT was 241.31 µm, a significantly lower value compared to the control group, 252.51. The average value of DVFC was 19.19%, in patients with DM and 24.29% in the control group. An indirect correlation with moderate intensity was established between total cholesterol and CRT, (rs=–0.442, p≤0.001), thus it tended to decrease as total cholesterol increased. With increasing total cholesterol level, DVFC had a mild tendency to decrease (rs=–0.381, p≤0.001). An indirect correlation, but weak in intensity, existed between the LDL/HDL ratio and the DVFC S value (rs=–0.240, p=0.001). Central retinal thickness and central vascular density of the superficial capillary plexus were significantly lower in patients with type II diabetes, compared to control subjects. Total cholesterol had higher values in the DM group and an indirect correlation was established with CRT and DVFC, these having a moderate tendency to decrease as the total cholesterol values increased. An indirect and moderate relationship in intensity was also present between LDL and retinal parameters studied. These results were similar to those of other studies conducted, such as that of Chen et al. or Bernaous et al., who showed an association between various lipid classes and the frequency of DR. However, other studies, such as Ausdiab, found that this association did not hold. Type II diabetes patients tend to have elevated serum lipid levels compared to normal subjects, but the impact of dyslipidemia on the onset and progression of DR is incompletely elucidated.