The role of the maternal and fetal inflammatory response in retinopathy of prematurity

Lynch, Anne M.; Berning, Amber; Thevarajah, Tamara S.; Wagner, Brandie D.; Post, Miriam D.; McCourt, Emily A.; Cathcart, Jennifer N.; Hodges, Jennifer; Mandava, Naresh; Gibbs, Ronald S.; Palestine, Alan G.

doi:10.1111/aji.12986

Cited by 21 publications

(11 citation statements)

References 38 publications

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“…In our own previous work, we have explored the hypothesis that perinatal inflammation is associated with an increased risk for ROP 4 – 6 . We 7 , 8 and others 9 – 11 have provided empirical evidence in support of this concept, buttressed by experimental data 12 – 14 .…”

Section: Introductionmentioning

confidence: 76%

Visuopathy of prematurity: is retinopathy just the tip of the iceberg?

et al. 2021

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Research on retinopathy of prematurity (ROP) focuses mainly on the abnormal vascularization patterns that are directly visible for ophthalmologists. However, recent findings indicate that children born prematurely also exhibit changes in the retinal cellular architecture and along the dorsal visual stream, such as structural changes between and within cortical areas. Moreover, perinatal sustained systemic inflammation (SSI) is associated with an increased risk for ROP and the visual deficits that follow. In this paper, we propose that ROP might just be the tip of an iceberg we call visuopathy of prematurity (VOP). The VOP paradigm comprises abnormal vascularization of the retina, alterations in retinal cellular architecture, choroidal degeneration, and abnormalities in the visual pathway, including cortical areas. Furthermore, VOP itself might influence the developmental trajectories of cerebral structures and functions deemed responsible for visual processing, thereby explaining visual deficits among children born preterm.

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Section: Introductionmentioning

confidence: 76%

Visuopathy of prematurity: is retinopathy just the tip of the iceberg?

et al. 2021

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“…VEGF-A and PIGF have been implicated to have a potential role in retinal neovascularization [29][30][31][32]. In recent studies, intrauterine inflammation, chronic placental inflammation, oxidative stress, and generalized inflammation are noted as major risk factors in the pathological angiogenesis, development, and progression of ROP in both human and animal studies [33][34][35][36][37][38]. Additionally, inflammatory mediators, such as IL-6, IL-18, cyclooxygenase-2, and IL-1ß, are elevated in OIR models of ROP.…”

Section: Discussionmentioning

confidence: 99%

Angiographic Review of Choroidal Involution in Eyes with Retinopathy of Prematurity Treated with Bevacizumab

Islam¹,

Andersen²,

Agarwal-Sinha³

2020

Ophthalmic Res

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Purpose: Retinopathy of prematurity (ROP) is considered a disease of the inner retina; however, there is increasing evidence that demonstrates choroidal vasculature loss in ROP, leading to degeneration of outer retinal function and visual deterioration. Central choroidal thinning is noted in children with history of ROP using optical coherence tomography (OCT) imaging. This study characterizes the presence and persistence of choroidal loss angiographically in eyes of infants treated with intravitreal bevacizumab (IVB) for stage 3 ROP. Methods: Retrospectively reviewed the fluorescein angiography (FA) images of 62 eyes of 31 infants treated with IVB monotherapy. The eyes with good quality early-, mid-, and late-phase imaging were included in this study. The presence of choroidal hypofluoresence involving the central and or peripheral retina were noted. In infants with multiple FAs, serial FAs were analyzed for persistence of choroidal hypofluorescence. Results: The mean age and birth weight of infants was 24.4 weeks PMA and 683 grams, respectively. All infants received IVB monotherapy. 24 of 62 angiography images of sufficient quality reviewed showed the presence of choroidal hypofluorescence involving central and peripheral lobular loss in the early phase and its persistence into mid and late phases. 12 eyes demonstrated persistent choroidal loss on sequential FA until three years chronological age. Conclusions: The study demonstrates the presence of choroidal vascular loss angiographically both central and peripheral fundus in infants with ROP. It highlights the critical role of choroidal involution in outer retinal function that could affect visual outcomes.

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“…In fact, infection could trigger the production of inflammatory markers (cytokines, chemokines, growth factors, etc.) that contribute to both arrest of vascularization in the first phase of ROP and aberrant neo-vascularization in the second phase 7 .…”

Section: Introductionmentioning

confidence: 99%

Early and late onset sepsis and retinopathy of prematurity in a cohort of preterm infants

Bonafiglia

Gusson

Longo

et al. 2022

Sci Rep

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This study investigates the impact of antenatal and postnatal infection or inflammation on the onset and progression of Retinopathy of Prematurity (ROP). We retrospectively collected clinical and demographic data of preterm infants with birth weight ≤ 1500 g or gestational age < 30 weeks admitted to the neonatal intensive care unit of Verona from 2015 to 2019. Uni- and multivariable analysis was performed to evaluate the potential effect of selected variables on the occurrence of any stage ROP and its progression to severe ROP, defined as ROP requiring treatment. Two hundred and eighty neonates were enrolled and 60 of them developed ROP (21.4%). Oxygen need for 28 days and late-onset sepsis (LOS) increased the risk of any grade ROP after adjusting for birth weight and gestational age (OR 6.35, 95% CI 2.14–18.85 and OR 2.49, 95% CI 1.04–5.94, respectively). Days of mechanical ventilation and of non-invasive ventilation increased the risk of progression to severe ROP after adjusting for birth weight and gestational age (OR 1.08, CI 1.02–1.14 and OR 1.06, CI 1.01–1.11, respectively). Exposure to infection with production of inflammatory mediators may contribute to increase the risk of ROP occurrence in very preterm neonates.

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The role of the maternal and fetal inflammatory response in retinopathy of prematurity

Abstract: Placental pathology distinguished by the maternal plus fetal inflammatory response was a significant risk factor for severe ROP. Our study supports a link between intrauterine inflammatory events and the subsequent development of severe ROP.

Cited by 21 publications

References 38 publications

Visuopathy of prematurity: is retinopathy just the tip of the iceberg?

Visuopathy of prematurity: is retinopathy just the tip of the iceberg?

Angiographic Review of Choroidal Involution in Eyes with Retinopathy of Prematurity Treated with Bevacizumab

Early and late onset sepsis and retinopathy of prematurity in a cohort of preterm infants

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