Which of the following is associated with an increased risk for ROP?

• A. Hyperglycemia
• B. Hypercalcemia
• C. Hyperphosphatemia
• D. Hypoglycemia

Answer: (A)

Retinopathy of prematurity risk rises when systemic conditions worsen oxidative stress and disrupt immature retinal vessels. Hyperglycemia contributes to this by increasing oxidative stress and inflammatory mediators, which damages the developing retinal vasculature and promotes abnormal neovascularization. In preterm infants, glucose dysregulation is commonly linked to worse outcomes, including more severe ROP, so keeping glucose within a normal range helps reduce risk. Hypercalcemia and hyperphosphatemia don’t have a direct, well-established link to ROP, and while hypoglycemia is harmful in many ways, the association with ROP is not as strong as that for hyperglycemia.