Though this study does not provide evidence of a direct causal relationship, these findings suggest that hyperglycemia may represent one of several interrelated biochemical markers or risk endotypes within the multifactorial spectrum of ROP—where glycemic-targeted interventions might be effective for some infants—while others may develop the disease through the well-established oxygen pathway, mixed VEGF-mediated mechanisms or via an alternative pathway. Here, VEGFA is linked to Hyperglycemia.