Wenwen CUI, Chang ZHAN, Tao WU, Qiong GAN, Weihua TANG
The Turkish Journal of Pediatrics - 2026;68(5):753-764
Background. Retinopathy of prematurity (ROP) remains a leading cause of childhood blindness. The microRNA-146a (miR-146a) rs2910164 polymorphism, implicated in angiogenesis and inflammation, may influence ROP pathogenesis, but its role is undefined. This study aimed to investigate the association of the miR-146a rs2910164 polymorphism with ROP susceptibility, disease severity, and complications. Methods. This retrospective case-control study included 196 preterm infants with ROP and 185 healthy preterm (HC) infants who were treated from January 2020 to December 2021 at our hospital. rs2910164 genotyping and miR-146a expression analysis using quantitative reverse transcriptase polymerase chain reaction were performed. Diagnostic potential was evaluated by receiver operating characteristic analysis. Associations with clinical features, disease severity (need for treatment for ROP), and complications were assessed. Results. Infants with ROP demonstrated significantly lower gestational age/birth weight and higher rates of intraventricular hemorrhage, bronchopulmonary dysplasia, and necrotizing enterocolitis than the HC infants (all P<0.001). miR-146a expression was an excellent diagnostic biomarker for ROP (AUC :0.918, 95% CI: 0.87-0.96). The CC genotype and C allele conferred a reduced risk of ROP. Among patients with ROP, CC/GC carriers had a lower likelihood of developing severe ROP that required treatment versus GG homozygotes. GG carriers also showed more severe manifestations and complications. Conclusion. The rs2910164 C allele is associated with protection from ROP susceptibility, correlates with upregulated miR-146a expression, and is further associated with milder disease manifestations, fewer complications, and a reduced need for clinical intervention. This polymorphism is a valuable predictive biomarker for ROP risk, severity, and prognosis, potentially mediated via miR-146a regulation.
