What are the benefits and risks of giving premature babies insulin-like growth factor-1 to prevent eye problems?
Current medical evidence does not support firm conclusions regarding the safety or efficacy of insulin-like growth factor-1 (IGF-1) as a treatment for retinopathy of prematurity. Research up to March 2025 indicates that existing studies involving premature infants weighing less than 1500 grams remain inconclusive, leaving the clinical role of this protein in preventing vision loss or blindness uncertain.
Did You Know? Insulin-like growth factor-1 is a naturally occurring protein that assists in the normal development of blood vessels in the retina during pregnancy; when infants are born prematurely, they may lack sufficient levels of this protein.
Understanding Retinopathy of Prematurity
Retinopathy of prematurity is a condition affecting infants born preterm, specifically those with a birth weight below 1500 grams. The disease occurs when the blood vessels in the back of the eye fail to develop correctly. If left unmanaged, this abnormal growth can lead to significant vision impairment or permanent blindness.
Standard care in neonatal intensive care units currently relies on two primary interventions. Physicians may use lasers to burn the retina, which stops the stimulation of abnormal blood vessels, or they may inject medications directly into the eye to temporarily halt vessel growth.
Analysis of Clinical Research
A review of existing research identified two studies involving 140 premature infants, tracking outcomes for up to six years. Researchers compared the administration of IGF-1 against standard neonatal care or placebo treatments to determine if the protein could effectively prevent or treat the disease.
The findings showed that current data is insufficient to establish whether IGF-1 provides a clinical benefit. Furthermore, the studies could not determine the safety profile of the treatment, specifically regarding the risk of harmful effects or mortality in these infants.
Expert Insight: The challenge here is the limited scope of available data. While the biological hypothesis—that replacing a missing protein could correct vessel growth—is scientifically grounded, the current evidence base lacks the scale and rigorous design needed to move this from a research concept to a standard clinical practice.
What May Happen Next
Because confidence in the current evidence is very low, future outcomes remain unpredictable. Researchers suggest that larger, more robustly designed studies are required to clarify if IGF-1 offers any therapeutic advantage. Until such trials are conducted, medical practitioners will likely continue to rely on established laser and injection therapies to manage retinopathy of prematurity.
Frequently Asked Questions
What is the primary function of insulin-like growth factor-1 in the eye?
It is a protein that helps blood vessels in the retina grow normally during the course of a pregnancy.
Why is there currently no consensus on using IGF-1 for premature babies?
The evidence is limited to two small studies with design issues, meaning researchers have not been able to detect clear benefits or confirm the safety of the treatment.
What are the risks associated with retinopathy of prematurity?
The condition can result in vision problems or total blindness if the abnormal growth of blood vessels in the back of the eye is not addressed.
How might future research change the current understanding of neonatal eye care?