Vascular and Neuronal Protection in the Developing Retina: Potential Therapeutic Targets for Retinopathy of Prematurity

Retinopathy of prematurity (ROP) is a common retinal disease in preterm babies. To prolong the lives of preterm babies, high oxygen is provided to mimic the oxygen level in the intrauterine environment for postnatal organ development. However, hyperoxia-hypoxia induced pathological events occur when babies return to room air, leading to ROP with neuronal degeneration and vascular abnormality that affects retinal functions. With advances in neonatal intensive care, it is no longer uncommon for increased survival of very-low-birth-weight preterm infants, which, therefore, increased the incidence of ROP. ROP is now a major cause of preventable childhood blindness worldwide. Current proven treatment for ROP is limited to invasive retinal ablation, inherently destructive to the retina. The lack of pharmacological treatment for ROP creates a great need for effective and safe therapies in these developing infants. Therefore, it is essential to identify potential therapeutic agents that may have positive ROP outcomes, especially in preserving retinal functions. This review gives an overview of various agents in their efficacy in reducing retinal damages in cell culture tests, animal experiments and clinical studies. New perspectives along the neuroprotective pathways in the developing retina are also reviewed.

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Severe sepsis and retinopathy of prematurity in very low birth weight preterm newborns in a third-level healthcare center in Lima, Peru between 2008 and 2018: A case-control study

Medwave ◽

10.5867/medwave.2021.03.8157 ◽

2021 ◽

Vol 21 (03) ◽

pp. e8157-e8157

Author(s):

Alvaro Valdivia ◽

Daniela Bullard Elias ◽

Cecilia Herbozo ◽

German Málaga

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Birth Weight ◽

Retinopathy Of Prematurity ◽

Odds Ratio ◽

Neonatal Intensive Care ◽

Very Low Birth Weight ◽

Late Onset ◽

Case Control ◽

Late Onset Sepsis

Background Retinopathy of prematurity is the leading worldwide cause of visual impairment. There is little available data on its epidemiology and related factors and consequences in developing countries such as Peru. Due to this lack of information, we decided to do this study. Objectives To evaluate factors related to the development of retinopathy of prematurity in very low birth weight newborn patients. Methods We did a case-control (paired 1:1) study of patients admitted to the Neonatal Intensive Care Unit of the Hospital Cayetano Heredia between 2008 and 2018 who had a complete record in the Neocosur network database (N = 293). The case was defined as a preterm newborn patient with a birth weight lower than 1500 grams who developed any type or stage of retinopathy of prematurity; control was defined as a patient with similar characteristics without retinopathy. Univariate and bivariate analysis (using logistic regression model) was performed to obtain the odds ratio with a 95% confidence interval. Results Data were obtained from 57 cases and 57 controls admitted to the Neonatal Intensive Care Unit at Hospital Cayetano Heredia. Late-onset sepsis was the main factor associated with retinopathy of prematurity (odds ratio 4.39; 95% confidence interval 1.23 to 15.76, p = 0.02). Additionally, we performed a bivariate and multivariate analysis that showed that exposure to supplementary oxygen at 36 weeks of postmenstrual age and retinopathy of prematurity were not significantly associated (8.47; 0.51 to 141.17, p = 0.14). Conclusions Patients with late-onset sepsis have a 4.39 times higher odds of developing retinopathy of prematurity. Prospective studies are needed with larger sample sizes.

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Case report of COVID-19 positive new born with necrotizing enterocolitis (NEC)

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20212891 ◽

2021 ◽

Vol 8 (8) ◽

pp. 1442

Author(s):

Rajshree Rajurkar ◽

Chanda Dangi ◽

Gunjan Kela

Keyword(s):

Case Report ◽

Necrotizing Enterocolitis ◽

Neonatal Intensive Care ◽

Very Low Birth Weight ◽

Case Reports ◽

High Incidence ◽

Preterm Babies ◽

Bowel Rest ◽

Severity Of The Disease ◽

Immune Defences

COVID-19 caused by SARS-Cov-2 virus has spread rapidly across the world. Children are just as like as adult to become infected with virus but have lesser symptoms and less severity of the disease. Necrotizing enterocolitis is one of the common gastrointestinal emergencies in neonatal intensive care unit. More than 85% of cases of NEC occur among preterm and very low birth weight. Preterm babies are vulnerable to develop NEC because of high incidence of perinatal distress factor, stasis of gut due to autonomic immaturity, poor barrier function of gut or immune defences, lack of feeding with human milk and higher incidence of nosocomial infections. During the current COVID-19 pandemic, no similar finding has been reported in the neonatal population to date. In this review we summarize the case report of two newborns admitted in our NICU who were COVID 19 positive presented to us with symptoms suggestive of necrotizing enterocolitis (NEC) and their outcome based on presence of comorbidity. Our case reports two case of two COVID-19 positive newborns admitted in our NICU with history, examination and investigations suggestive of necrotizing enterocolitis. Early initiation of antibiotics covering bowel flora, bowel rest and resuscitation, similar to our tried and true medical management of NEC, should be considered for initial management to avoid surgical intervention

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Retinopathy of Prematurity: Nursing Perspective

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/47267.14737 ◽

2021 ◽

Author(s):

Bindu K Sankar ◽

Hrishikesh Amin ◽

KM Riaz ◽

P Pappa ◽

Shalu Varghese

Keyword(s):

Retinopathy Of Prematurity ◽

Neonatal Intensive Care ◽

Vital Role ◽

Neonatal Intensive Care Units ◽

Postnatal Life ◽

Middle Income ◽

Middle Income Countries ◽

Care Givers ◽

Preterm Babies

Retinopathy of Prematurity (ROP) is the leading cause of childhood blindness. India and other middle income countries are currently facing the third ‘epidemic’ of this disease which is mainly due to increased survival of preterm babies, suboptimal neonatal care and lack of proper screening and management of ROP. This is a disorder of the immature retina of preterm babies in which abnormal vascularisation occurs after birth. ROP is multifactorial, and is sensitive to the quality of neonatal inpatient care received during early postnatal life. Nurses, being the primary care givers in Neonatal Intensive Care Units (NICUs), plays a vital role in prevention and management of ROP.

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Retinopathy of prematurity in the period 2015-2019 in a tertiary referral centre in Slovenia

Slovenian Medical Journal ◽

10.6016/zdravvestn.3085 ◽

2021 ◽

pp. 1-8

Author(s):

Manca Tekavčič Pompe ◽

Špela Markelj ◽

Liljana Kornhauser Cerar

Keyword(s):

Retinopathy Of Prematurity ◽

Neonatal Intensive Care ◽

Very Low Birth Weight ◽

Tertiary Referral ◽

Tertiary Referral Centre ◽

Screening Criteria ◽

Number Of Children ◽

Extremely Preterm ◽

Gestational Week ◽

Rop Screening

Background: Retinopathy of prematurity (ROP) is the leading cause of blindness among prematurely born children. The incidence of any stage of ROP in children born before the 31st gestational week in Europe and the USA is between 10-45%. The purpose of this study was to show characteristics of ROP between 2015 and 2019 at the Neonatal Intensive Care Unit of the University Medical Centre Ljubljana (NICU-Lj), which is the larger of the two tertiary referral centres in Slovenia and in which more than two thirds of Slovenian very low birth weight children are treated. Methods: All prematurely born children screened for ROP at NICU-Lj between 2015 and 2019 were included in the study. The following parameters were recorded: number of children screened, total number of exams, number of exams per child, number of children with ROP, ROP stages, number of children who needed ROP treatment and number of treatments per child treated. Results: Between 2015 and 2019, 82-130 prematurely born children fulfilled ROP screening criteria each year. A total of 1,412 exams were performed over the period of five years (range: 239-386 per year). Every child had one or more ROP screening exams (range: 1-10). Extremely preterm children born before the 27th week of gestation had more exams (average: 5 exams/child) compared to other prematurely born children (average: 1.5 exams/child). The number of prematurely born children with any stage of ROP ranged from 17 to 30 per year. ROP of any stage was present in 18.75% (2015), in 17.7% (2016), in 23% (2017), in 29.3% (2018), and in 24.1% (2019). More than 70% of all babies with ROP were born before the 27th gestational week. The most mature baby with ROP was born with 29 6/7 weeks of gestational age. Every year, 15-35% of babies with ROP received laser treatment. Conclusions: ROP is an important disease in prematurely born children. During the period 2015-2019, the incidence of any stage of ROP and of serious ROP requiring treatment was comparable. The screening and treatment of ROP requires intense cooperation between paediatric ophthalmologists and neonatologists in order to prevent blindness in prematurely born children.

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RETINOPATHY OF PREMATURITY AND RISK FACTORS IN VERY LOW BIRTH WEIGHT INFANTS IN A NEONATAL INTENSIVE CARE UNIT IN A UNIVERSITY HOSPITAL IN BRAZIL

10.26226/morressier.5b5f4339b56e9b005965b3b7 ◽

2018 ◽

Author(s):

Silvana NADER ◽

Paulo de Jesus NADER ◽

Tatiana Siviero

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Intensive Care ◽

Birth Weight ◽

Neonatal Intensive Care Unit ◽

Retinopathy Of Prematurity ◽

Neonatal Intensive Care ◽

Very Low Birth Weight ◽

University Hospital ◽

Low Birth Weight Infants

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Incidence and risk factors of retinopathy of prematurity in Goa, India: a report from tertiary care centre

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20192017 ◽

2019 ◽

Vol 6 (3) ◽

pp. 1228

Author(s):

Sarvesh Kossambe ◽

Shilpa Joglekar ◽

Annely D'lima ◽

M. P. Silveira

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Retinopathy Of Prematurity ◽

Neonatal Intensive Care ◽

Laser Photocoagulation ◽

Very Low Birth Weight ◽

Care Center ◽

Tertiary Care ◽

Preterm Neonates ◽

Tertiary Care Centre

Background: To report the incidence and risk factors leading to the development of retinopathy of prematurity (ROP) from a tertiary care center in the western Indian state of Goa, India.Methods: This was a prospective observational study carried out in a level II neonatal intensive care unit (NICU) for a period of 18 months. Babies born at < 34 weeks’ gestation and having a birth weight of <1500gm were screened for ROP and laser photocoagulation was done for those who developed threshold ROP. Group differences between any ROP and threshold ROP were analysed using the chi-square test.Results: Out of the 244 preterm neonates screened, 37 developed ROP (15.16%), and 14 out of them (5.73%) developed threshold ROP requiring laser photocoagulation. Very low birth weight, prematurity, apnea, anemia, sepsis, respiratory distress syndrome, bronchopulmonary dysplasia, blood transfusions, exchange transfusions and days taken to reach full enteral feeds and regain birth weight were significantly associated with the development of ROP.Conclusions: This is the first report of ROP from Goa where less than 1 in 5 babies developed ROP. This is similar to that reported across the rest of the country. Judicious oxygen use, ventilation strategies, transfusions guidelines, control of sepsis, early enteral feeds and adequate nutrition may help prevent the development of ROP in the future.

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Weight gain measured at 6 weeks after birth as a predictor for severe retinopathy of prematurity: study with 317 very low birth weight preterm babies

Graefe s Archive for Clinical and Experimental Ophthalmology ◽

10.1007/s00417-008-1012-3 ◽

2008 ◽

Vol 247 (6) ◽

pp. 831-836 ◽

Cited By ~ 45

Author(s):

Joao Borges Fortes Filho ◽

Pedro P. Bonomo ◽

Mauricio Maia ◽

Renato S. Procianoy

Keyword(s):

Weight Gain ◽

Birth Weight ◽

Low Birth Weight ◽

Retinopathy Of Prematurity ◽

Very Low Birth Weight ◽

Preterm Babies

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Retinopathy of Prematurity: Incidence and Risk Factors

PEDIATRICS ◽

10.1542/peds.72.2.159 ◽

1983 ◽

Vol 72 (2) ◽

pp. 159-163 ◽

Cited By ~ 1

Author(s):

Mordechai Shohat ◽

Salomon H. Reisner ◽

R. Krikler ◽

Ilana Nissenkorn ◽

Yuval Yassur ◽

...

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Retinopathy Of Prematurity ◽

Medical Records ◽

Neonatal Intensive Care ◽

Very Low Birth Weight ◽

Low Birth Weight Infants ◽

Frequent Monitoring ◽

High Incidence ◽

Yearly Incidence

A high incidence of retinopathy of prematurity (ROP) was found in the very low-birth-weight infants discharged from the neonatal intensive care unit during the years 1977 to 1980, in spite of frequent monitoring of oxygen use. Although the yearly incidence of ROP in infants weighing <1,500 g varied between 35% to 36%, none were blind. The medical records of 65 infants with a birth weight between 501 and 1,250 g, surviving in 1979 to 1980, were reviewed in order to find risk factors for ROP. There were no significant differences between the 34 infants with ROP and the 31 infants who did not have ROP in mean birth weight or mean gestational age. Of 32 possible risk factors examined, the factors significantly associated with ROP were: apnea with mask and bag ventilation; prolonged parenteral nutrition; number of blood transfusions; and episodes of hypoxemia, hypercarbia, and hypocarbia. A highly significant association between hypocarbia and the development of severe ROP was found.

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