80 Years of vision: preventing blindness from retinopathy of prematurity

Wood, Edward H.; Chang, Emmanuel; Beck, Kinley; Hadfield, Brandon R.; Quinn, Amy; Harper, C. Armitage

doi:10.1038/s41372-021-01015-8

Cited by 28 publications

(26 citation statements)

References 68 publications

(70 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Nevertheless, at variance with other studies, we included in the analysis only patients receiving transfusions and with GA at birth conveying a reasonable risk for severe ROP development. Finally, the study investigated the occurrence of severe ROP and not all stages of ROP: importantly, among various ROP stages, severe ROP has a foremost clinical impact, frequently requiring proper treatment or even evolving to blindness ( 2 ).…”

Section: Discussionmentioning

confidence: 99%

“…Along with the decline of mortality, attention has been focused on long-term morbidities and related functional impairments,which lifelong affect the quality of life of “born too soon” neonates ( 1 ). Among them, the retinopathy of prematurity (ROP) still represents one of the major causes of blindness in childhood ( 2 , 3 ). The pathogenesis of ROP relies on an initial phase of vessel growth inhibition, followed by hypoxia-induced neovascularization in the retina becoming metabolically active ( 4 ).…”

Section: Introductionmentioning

confidence: 99%

“…After the initial description of ROP, it has been rapidly recognized that excessive oxygen exposure promotes disease development ( 6 ). Despite current oxygen therapy protocols preventing hyperoxia through controlled supplementation, many preterm neonates still experience severe forms of ROP and frequently require appropriate treatments ( 2 , 3 ). Among other risk factors, repeated red blood cell (RBC) transfusions are alleged to favor the ROP development.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Transfusion-Free Survival Predicts Severe Retinopathy in Preterm Neonates

Teofili¹,

Papacci

Bartolo³

et al. 2022

Front. Pediatr.

View full text Add to dashboard Cite

Repeated red blood cell (RBC) transfusions are thought to increase the risk for retinopathy of prematurity (ROP), likely due to a critical fetal hemoglobin (HbF) reduction. In this study, we investigated if the postmenstrual age (PMA) of neonates at transfusion influences the risk for ROP. We estimated the cumulative transfusion-free survival (TFS) in a series of 100 preterm neonates receiving one or more RBC units. TFS was calculated by censoring patients at first transfusion and expressing the time between birth and transfusion as either PMA or postnatal day. Then, we investigated if TFS predicted the occurrence of severe ROP, defined as ROP stage 3 or higher. We found that neonates with severe ROP displayed a significantly shorter TFS expressed according to their PMA (p = 0.001), with similar TFS according to postnatal days. At receiver operating characteristic (ROC) curve analysis, receiving an RBC unit before week 28 of PMA predicted severe ROP with a sensitivity of 64% and a specificity of 78%. In addition, receiving a second RBC unit before the PMA of 29 weeks predicted severe ROP with a sensitivity of 75% and a specificity of 69%. At multivariate analysis, PMA at the second transfusion was even more informative than at first transfusion and outperformed all other variables in predicting severe ROP, with an odds ratio of 4.554 (95% CI 1.332–15.573, p = 0.016). Since HbF decrease is greater after multiple RBC transfusions, it is conceivable that neonates receiving more than one unit before the PMA of 29 weeks may be exposed to a greater disturbance of retinal vascularization. Any strategy aimed at preventing the critical HbF decrease at this low age might potentially reduce the risk for severe ROP.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Transfusion-Free Survival Predicts Severe Retinopathy in Preterm Neonates

Teofili¹,

Papacci

Bartolo³

et al. 2022

Front. Pediatr.

View full text Add to dashboard Cite

show abstract

“…Despite good outcomes achieved in the care of prematurely born infants, ROP remains a major cause of visual impairment and blindness in children. Global statistics show that at least 50,000 children to date have lost vision due to ROP [1]. Thanks to the application of the latest guidelines addressing such aspects as optimal oxygen therapy, ROP screening strategies, and effective treatment modalities, the number of cases of stage 1 ROP has decreased significantly in recent years, while the total number of premature infants requiring treatment is equivalent to 3-5% of children undergoing screening [1].…”

Section: Introductionmentioning

confidence: 99%

Risk factors for retinopathy of prematurity: a current literature review

Modrzejewska¹,

Czyżewska²,

Bosy-Gąsior³

et al. 2022

View full text Add to dashboard Cite

Aim of the study:To present the primary and secondary risk factors for the development of retinopathy of prematurity (ROP), as reported in the literature to date. Material and methods: Analysis of scientific papers and articles available in the PubMed, Google Scholar and UpToDate databases devoted to the study of risk factors involved in the development of retinopathy in premature infants, with attention given to the WIN-ROP and G-ROP algorithms used in ophthalmic screening tests. Conclusions:The best documented risk factors with a direct impact on ROP include low birth weight and preterm birth, low IGF-1 level, chorioamnionitis, and neonatal sepsis, while factors with an indirect impact on the development of ROP comprise bronchopulmonary dysplasia, necrotizing enterocolitis, apnea of prematurity, and respiratory distress syndrome (RDS).

show abstract

“…Retinopathy of prematurity (ROP) is considered one of the primary causes of pediatric visual impairment. [ 1 ] ROP pathophysiology involves two distinctive stages, in which vascular endothelial growth factor (VEGF) levels markedly differ. Phase 1 (vaso-obliterative) extends approximately over 22–30 weeks' postmenstrual age (PMA), where the levels of VEGF are suppressed and Phase 2 (vasoproliferative), from around 31–44 weeks' PMA, where there is an overproduction of VEGF.…”

Section: Introductionmentioning

confidence: 99%