ROP is a proliferative retinopathy that occurs in low-birth-weight or premature infants. It is a leading cause of blindness in this population, primarily characterized by the abnormal proliferation of retinal blood vessels [
167]. The main risk factors for ROP include premature birth, low birth weight, and exposure to high concentrations of oxygen after birth. Retinal neovascularization is the key pathological feature of ROP, leading to retinal ischemia, hypoxia, leakage, and a persistent inflammatory response. Over time, this damages retinal function, resulting in severe vision loss or even blindness. Although intravitreal injections of anti-VEGF drugs are commonly used to inhibit retinal neovascularization in ROP patients, this method could cause various postoperative complications and pose risks to the development of the retina, brain, and other organs in infants [
168]. Therefore, alternative routes of administration are urgently needed for effective treatment. In this regard, Bohley
et al. [
169] developed LNCs loaded with both anti-inflammatory and anti-VEGF drugs (Fig. S4C in Supporting information). They evaluated the therapeutic effects of these nanocapsules through intravenous administration. Cyclodextrin was embedded within the LNCs, enhancing their ability to pass through cellular barriers and improving their affinity and specificity for retinal cells. The results demonstrated that intravenous injection of LNCs effectively inhibited retinal neovascularization, reduced retinal inflammation, and had a therapeutic effect on ROP without impairing retinal development. EXOs are naturally occurring NPs secreted by various cell types. Due to their non-toxic, biodegradable, and highly biocompatible nature, EXOs are considered ideal carriers for drug delivery. They can efficiently penetrate biological barriers within the eye, offering strong drug delivery capabilities. Dong
et al. [
170] engineered EXOs loaded with anti-angiogenic peptides and assessed their delivery efficiency and therapeutic effects
via retroorbital and intravitreal injections. The EXOs were able to efficiently deliver the peptides to the retina, inhibiting retinal neovascularization and vascular leakage. Notably, retroorbital injection provided the same drug delivery efficiency and therapeutic effect as intravitreal injection, offering a less invasive alternative for ROP treatment. Moreover, some studies have indicated that graphene quantum dots possess anti-tumor properties [
171]. Given the similarities between retinal neovascularization and tumor growth, Zhao
et al. [
172] investigated the potential anti-angiogenic effects of graphene quantum dots. Their results showed that graphene quantum dots not only inhibited the proliferation and sprouting of retinal vascular endothelial cells
in vitro but also reduced retinal neovascularization
in vivo, suggesting their potential as a new treatment for retinal neovascularization in ROP. Additionally, Jian
et al. [
173] synthesized a novel carbon nanomaterial using sodium alginate and 1,8-diaminooctane
via mild pyrolysis. This material demonstrated effective ROS scavenging, VEGF inhibition, and anti-inflammatory effects in a rabbit eye model, highlighting its potential as an effective therapeutic for retinal neovascularization. Xue
et al. [
174] developed a noninvasive fluorinated and RGD-modified ruthenium polymer nanozyme (FR-PolyRu) eye drop by encapsulating antioxidant PolyRu nanozyme within fluoridated liposomes. These eye drops can penetrate the ocular barrier through enhanced membrane permeability
via fluorination, RGD-mediated targeting, and nanoenzyme-catalyzed oxygen-driven active transport after local administration. This combined action effectively inhibits pathological retinal neovascularization in oxygen-induced retinopathy (OIR) mice, offering a safe and effective non-invasive strategy for treating related diseases.