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Vyas A, Tiwari S, Subramanyam A. Safety and therapeutic efficacy of 577 nm yellow solid krypton laser for retinopathy of prematurity; A prospective pilot study. Indian J Ophthalmol 2024; 72:856-859. [PMID: 38317309 DOI: 10.4103/ijo.ijo_2490_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 11/24/2023] [Indexed: 02/07/2024] Open
Abstract
PURPOSE To evaluate the outcome of 577 nm yellow solid krypton laser as an independent treatment modality for Retinopathy of Prematurity. DESIGN Prospective, non-comparative, non-randomized, interventional. METHODS A prospective pilot study was conducted on 30 treatment eyes with retinopathy of prematurity (ROP) who underwent treatment with a 577 nm yellow solid state krypton laser. 3nethraNEO pediatric retinal imaging system was used to screen these infants born between March to August 2022. Pre procedure data such as gestational age (weeks), birth weight (g), and exposure to risk factors were recorded. Power (mW), exposure duration (msec), and number of laser spots administered were noted. Pain was assessed using the Neonatal Pain/Agitation and Sedation Scale (N-PASS). Post procedure data such as regression, persistence or reactivation of disease, and adverse effects were looked for. All eyes were followed up for a period of 3 months. STATISTICAL ANALYSIS USED Chi-square test, Fisher's exact test. RESULTS Out of 30 eyes, 09 (30%) had type I and 21 (70%) had non-type I ROP. In type I disease, the mean power used was 88+/-10 mW with exposure duration of 130+/-27 msec and an average number of 890+/-260 burns were administered. In non-type I disease, the mean power used was 87+/-10 mW with an exposure duration of 150 ms and an average number of 900+/-290 burns were administered. The mean pain score calculated was 5 in type I and 6 in non-type I ROP. All eyes showed regression of disease after treatment. CONCLUSION 577 nm yellow solid krypton laser was safe and effective in treating retinopathy of prematurity disease.
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Affiliation(s)
- Aneesha Vyas
- Vitreo-Retina Department, K B H Bachooali Charitable Ophthalmic and ENT Hospital, Mumbai, Maharashtra, India
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2
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Jia Q, Wang X, Li X, Xie C, Zhang Q, Mu J, Yang W. Analysis of research hotspots and trends in pediatric ophthalmopathy based on 10 years of WoSCC literature. Front Pediatr 2024; 12:1405110. [PMID: 38873588 PMCID: PMC11171143 DOI: 10.3389/fped.2024.1405110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 05/20/2024] [Indexed: 06/15/2024] Open
Abstract
Background Ophthalmopathy occurring in childhood can easily lead to irreversible visual impairment, and therefore a great deal of clinical and fundamental researches have been conducted in pediatric ophthalmopathy. However, a few studies have been performed to analyze such large amounts of research using bibliometric methods. This study intended to apply bibliometric methods to analyze the research hotspots and trends in pediatric ophthalmopathy, providing a basis for clinical practice and scientific research to improve children's eye health. Methods Publications related to pediatric ophthalmopathy were searched and identified in the Web of Science Core Collection (WoSCC) database. Bibliometric and visualized analysis was performed using the WoSCC analysis system and CiteSpace.6.2.6 software, and high-impact publications were analyzed. Results This study included a total of 7,177 publications from 162 countries and regions. Of these, 2,269 from the United States and 1,298 from China. The centrality and H-index were highest in the United States at 0.27 and 66, respectively. The University of London and Harvard University had the highest H-index at 37. Freedman,Sharon F published 55 publications, with the highest H-index at 19. The emerging burst keyword in 2020-2023 was "eye tracking," and the burst keywords in 2021-2023 were "choroidal thickness," "pediatric ophthalmology," "impact" and "childhood glaucoma." Retinopathy of prematurity, myopia, retinoblastoma and uveitis in juvenile idiopathic arthritis were the main topics in the high-impact publications, with clinical studies in the majority, especially in retinopathy of prematurity. Conclusion Eye health in children is a research hotspot, with the United States publishing the largest number of papers and having the greatest influence in research on pediatric ophthalmopathy, and China coming in second. The University of London and Stanford University had the greatest influence. Freedman, Sharon F was the most influential author. Furthermore, "choroidal thickness," "pediatric ophthalmology," "impact," "childhood glaucoma" and "eye tracking"are the latest hotspots in the field of pediatric ophthalmopathy. These hotspots represent hot diseases, hot technologies and holistic concepts, which are exactly the research trends in the field of pediatric ophthalmopathy, providing guidance and grounds for clinical practice and scientific research on children's eye health.
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Affiliation(s)
- Qianfang Jia
- Department of Children Rehabilitation, First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
- Xinxiang Autism Integration Education Engineering Technology Research Center, Xinxiang, China
| | - Xiaofang Wang
- Hebei University of Chinese Medicine, Shijiazhuang, China
| | - Xiwan Li
- Department of Children Rehabilitation, First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Cuijuan Xie
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen, China
| | - Qing Zhang
- The Third Affiliated Hospital of Xinxiang Medical University, Xinxiang Medical University, Xinxiang, China
| | - Jingfeng Mu
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen, China
| | - Weihua Yang
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen, China
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3
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Tian Y, Fan Z, Zeng X, Yu Z, Lu X, Zhao X, Wu Z, He H, Zeng J, Zheng L, Zhang L, Correa VSMC, Ying G, Zhang S, Zhang G. Long-term follow-up of the cognitive function in children after intravitreal ranibizumab for retinopathy of prematurity. Graefes Arch Clin Exp Ophthalmol 2024:10.1007/s00417-024-06486-x. [PMID: 38643422 DOI: 10.1007/s00417-024-06486-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 03/26/2024] [Accepted: 04/04/2024] [Indexed: 04/22/2024] Open
Abstract
PURPOSE To evaluate the long-term cognitive function in children treated with intravitreal ranibizumab (IVR) for retinopathy of prematurity(ROP), and the impact of IVR on the growth and ocular development. METHODS In this retrospective study, the premature children aged 4 to 9 years who received monotherapy of IVR (IVR group, n = 25) or monotherapy of laser photocoagulation (LP) (LP group, n = 33) for ROP, and the same age premature children with no ROP (Control group, n = 26) were enrolled from 2020 to 2022 in the pediatric fundus clinic of Shenzhen Eye Hospital. Main outcome measures were full-scale intelligence quotient (FSIQ) and index score using the Chinese version of the Wechsler intelligence scale for children-fourth edition (WISC-IV) and Wechsler preschool and primary scale of intelligence-fourth edition (WPPSI-IV). All children were examined and analyzed for growth and ocular development by recording the height, weight, head circumference, spherical equivalent (SE), best corrected visual acuity (BCVA) and axial length (AL). RESULTS There were 17 children in IVR group, 17 in LP group, and 11 in Control group who received the WISC-IV assessment. There were no significant differences in FSIQ, verbal comprehension index, perceptual reasoning index, working memory index, processing speed index, general ability index and cognitive efficiency index among the three groups. There were 8 children in IVR group, 16 in LP group, and 15 in Control group who received the WPPSI-IV assessment. There were no significant differences in FSIQ, verbal comprehension index, visuospatial index, fluid reasoning index, working memory index, non-verbal index, general ability index and cognitive efficiency index among the three groups. There was no significant difference in BCVA among the three groups (P = 0.74), however, there is an increase for AL in IVR group when compared with LP group (22.60 ± 0.58 vs. 22.13 ± 0.84, P = 0.003), and the ROP patients of IVR group have a significant increase in the AL compared to the Control group(22.60 ± 0.58 vs. 22.03 ± 0.71, P < 0.0001). CONCLUSIONS Children with a history of IVR have a similar cognitive function outcomes compared to those with a history of LP or were premature without ROP. ROP children with a history of IVR has longer AL than those treated with LP.
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Affiliation(s)
- Ya Tian
- Department of Ophthalmology, Guizhou Provincial People's Hospital, 18 Zhongshan East Road, Guiyang, 550002, Guizhou, China
| | - Zixin Fan
- Department of Pediatric Retinal Surgery, Shenzhen Eye Hospital, 18 Zetian Road, Shenzhen, 518040, Guangdong, China
| | - Xianlu Zeng
- Department of Pediatric Retinal Surgery, Shenzhen Eye Hospital, 18 Zetian Road, Shenzhen, 518040, Guangdong, China
| | - Zhen Yu
- Department of Pediatric Retinal Surgery, Shenzhen Eye Hospital, 18 Zetian Road, Shenzhen, 518040, Guangdong, China
| | - Xiaofeng Lu
- Department of Pediatric Retinal Surgery, Shenzhen Eye Hospital, 18 Zetian Road, Shenzhen, 518040, Guangdong, China
| | - Xinyu Zhao
- Department of Pediatric Retinal Surgery, Shenzhen Eye Hospital, 18 Zetian Road, Shenzhen, 518040, Guangdong, China
| | - Zhenquan Wu
- Department of Pediatric Retinal Surgery, Shenzhen Eye Hospital, 18 Zetian Road, Shenzhen, 518040, Guangdong, China
| | - Honghui He
- Department of Pediatric Retinal Surgery, Shenzhen Eye Hospital, 18 Zetian Road, Shenzhen, 518040, Guangdong, China
| | - Jian Zeng
- Department of Pediatric Retinal Surgery, Shenzhen Eye Hospital, 18 Zetian Road, Shenzhen, 518040, Guangdong, China
| | - Lei Zheng
- Department of Pediatric Retinal Surgery, Shenzhen Eye Hospital, 18 Zetian Road, Shenzhen, 518040, Guangdong, China
| | - Linlin Zhang
- Department of Child Health Care, Shenzhen Children's Hospital, 7019 Yitian Road, Shenzhen, 518040, Guangdong Province, China
| | - Victor S M C Correa
- Retina Service, Ines and Fred Yeatts Retina Research Laboratory, Angiogenesis Laboratory, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, 02114, USA
| | - Guishuang Ying
- Center for Preventative Ophthalmology and Biostatistics, Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 700, Philadelphia, PA, 19104, USA
| | - Shaochong Zhang
- Department of Pediatric Retinal Surgery, Shenzhen Eye Hospital, 18 Zetian Road, Shenzhen, 518040, Guangdong, China
| | - Guoming Zhang
- Department of Pediatric Retinal Surgery, Shenzhen Eye Hospital, 18 Zetian Road, Shenzhen, 518040, Guangdong, China.
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Lu F, Chen Q, Tang Y, Yao D, Yin Y, Liu Y. Image-free recognition of moderate ROP from mild with machine learning algorithm on plasma Raman spectrum. Exp Eye Res 2024; 239:109773. [PMID: 38171476 DOI: 10.1016/j.exer.2023.109773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 12/17/2023] [Accepted: 12/28/2023] [Indexed: 01/05/2024]
Abstract
The retinopathy of prematurity (ROP) can cause serious clinical consequences and, fortunately, it is remediable while the time window for treatment is relatively narrow. Therefore, it is urgent to screen all premature infants and diagnose ROP degree timely, which has become a large workload for pediatric ophthalmologists. We developed a retinal image-free procedure using small amount of blood samples based on the plasma Raman spectrum with the machine learning model to automatically classify ROP cases before medical intervention was performed. Statistical differences in infrared Raman spectra of plasma samples were found among the control, mild (ZIIIS1), moderate (ZIIIS2 & ZIIS1), and advanced (ZIIS2) ROP groups. With the different wave points of Raman spectra as the inputs, the outputs of our support vector machine showed that the area under the curves in the receiver operating characteristic (AUC) were 0.763 for the pair comparisons of the control with the mild groups, 0.821 between moderate and advanced groups (ZIIS2), while more than 90% in comparisons of the other four pairs: control vs. moderate (0.981), control vs. advanced (0.963), mild vs. moderate (0.936), and mild vs. advanced (0.953), respectively. Our study could advance principally the ROP diagnosis in two dimensions: the moderate ROPs have been classified remarkably from the mild ones, which leaves more time for the medical treatments, and the procedure of Raman spectrum with a machine learning model based on blood samples can be conveniently promoted to those hospitals lacking of the pediatric ophthalmologists with experience in reading retinal images.
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Affiliation(s)
- Fang Lu
- Department of Ophthalmology, West China Hospital, Sichuan University, 37# Guo Xue Xiang Rd, Chengdu, China
| | - Qin Chen
- Department of Ophthalmology, West China Hospital, Sichuan University, 37# Guo Xue Xiang Rd, Chengdu, China
| | - Yezhong Tang
- Chengdu Institute of Biology, Chinese Academy of Sciences, 4-9 South Renmin Rd, Chengdu, China
| | - Dezhong Yao
- University of Electronic Science and Technology of China, 2006 Xiyuan Avenue, Chengdu, China
| | - Yu Yin
- Chengdu Pano AI Intelligent Technology Co., Ltd., 200 Tianfu Fifth Street, Chengdu, China.
| | - Yang Liu
- Chengdu Institute of Biology, Chinese Academy of Sciences, 4-9 South Renmin Rd, Chengdu, China.
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Wong TL. Addressing the Challenges of Smartphone-Based Telescreening for Retinopathy of Prematurity. JAMA Ophthalmol 2023; 141:1004. [PMID: 37676685 DOI: 10.1001/jamaophthalmol.2023.4031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Affiliation(s)
- Thai Ling Wong
- Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
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Athikarisamy SE, Vinekar A, Patole S. Retinopathy of prematurity in India - what can we learn from the polio legacy? THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2023; 14:100210. [PMID: 37492414 PMCID: PMC10363497 DOI: 10.1016/j.lansea.2023.100210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/01/2023] [Accepted: 04/25/2023] [Indexed: 07/27/2023]
Abstract
Retinopathy of prematurity (ROP) is a vasoproliferative disease of the preterm retina that has the potential to cause vision impairment and blindness. Timely screening and treatment are hence critical for infants at risk for ROP. Screening for ROP is challenging in India owing to the limited resources, a vast at-risk population and lack of awareness among paediatricians and the public. Addressing ROP in India requires a comprehensive approach involving multiple sectors, considering the magnitude of the problem and the expected increase in need for ROP services due to the increased survival of preterm infants following improvements in neonatal care. The success of the Global Polio Eradication Initiative (GPEI) offers valuable lessons for improving ROP services in developing nations by applying its strategies. An approach for primary and secondary prevention of ROP is proposed, and the current challenges and a neonatal-led care model for ROP are discussed.
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Affiliation(s)
- Sam Ebenezer Athikarisamy
- Neonatal Directorate, Child Adolescent Health Service, Perth, Western Australia, Australia
- School of Medicine, University of Western Australia, Crawley, Western Australia, Australia
| | - Anand Vinekar
- Director, KIDROP, Narayana Nethralaya Eye Institute, Bangalore, India
| | - Sanjay Patole
- Neonatal Directorate, Child Adolescent Health Service, Perth, Western Australia, Australia
- School of Medicine, University of Western Australia, Crawley, Western Australia, Australia
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Cheng H, Cao D, Qian J, Gu W, Zheng Z, Ma M. Refractive status and retinal morphology in children with a history of intravitreal ranibizumab for retinopathy of prematurity. Eur J Pediatr 2023:10.1007/s00431-023-04965-7. [PMID: 37097446 DOI: 10.1007/s00431-023-04965-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 03/20/2023] [Accepted: 03/30/2023] [Indexed: 04/26/2023]
Abstract
This study investigated the characteristics of refractive status, visual acuity, and retinal morphology in children with a history of receiving intravitreal ranibizumab for retinopathy of prematurity (ROP). Children 4-6 years of age were enrolled and divided into the following four groups: group 1, children with a history of ROP who had been treated with intravitreal ranibizumab; group 2, children with a history of ROP who had not received any treatment; group 3, premature children without ROP; and group 4, full-term children. Refractive status, peripapillary retinal nerve fiber layer (RNFL), and macular thickness were measured. A total of 204 children were enrolled. In group 1, myopic shift was not noted, but poorer best corrected visual acuity (BCVA) and shorter axial length were observed. Significantly lower peripapillary RNFL thickness in the average total and superior quadrant, higher central subfield thickness, lower parafoveal retinal thickness in average total, superior, and nasal and temporal quadrants were observed in group 1 than in the other groups. The poor BCVA in patients with ROP was correlated with the lower RNFL thickness in the superior quadrant. Conclusion: Children with a history of type 1 ROP treated with ranibizumab did not show a myopic shift but did show abnormal retinal morphology and the poorest BCVA among all groups. We suggest that pediatric ophthalmologists should always pay attention to visual development in patients with ROP with a history of intravitreal ranibizumab. What is Known: • Anti-VEGF is efficiently and widely used in the treatment of type 1 retinopathy of prematurity (ROP), and different anti-VEGF agents are associated with different prevalence of myopia. • Patients with ROP who receive treatment such as laser therapy or cryotherapy have abnormal macular development and retinal nerve fiber layer (RNFL) thickness. What is New: • Children with a history of ROP treated with intravitreal ranibizumab did not show a myopic shift but did show poor BCVA at 4-6 years of age. • Abnormal macular morphology and lower peripapillary RNFL thickness were found in these children.
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Affiliation(s)
- Haixia Cheng
- Department of Ophthalmology, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Ophthalmology, Shanghai General Hospital of Nanjing Medical University, Shanghai, China
| | - Di Cao
- Department of Ophthalmology, Shanghai General Hospital of Nanjing Medical University, Shanghai, China
- Department of Ophthalmology, Wuxi Maternity and Child Health Care Hospital, Women's Hospital of Jiangnan University, Jiangnan University, Wuxi, Jiangsu, China
| | - Jing Qian
- Department of Ophthalmology, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Wei Gu
- Department of Quality Management, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Zhi Zheng
- Department of Ophthalmology, Shanghai General Hospital of Nanjing Medical University, Shanghai, China.
- Department of Ophthalmology, Shanghai General Hospital; National Clinical Research Center for Eye Diseases; Shanghai Key Laboratory of Ocular Fundus Diseases; Shanghai Engineering Center for Visual Science and Photomedicine; Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, No. 85, Wujin Road, Hongkou District, Shanghai, China.
| | - Mingming Ma
- Department of Ophthalmology, Shanghai General Hospital; National Clinical Research Center for Eye Diseases; Shanghai Key Laboratory of Ocular Fundus Diseases; Shanghai Engineering Center for Visual Science and Photomedicine; Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, No. 85, Wujin Road, Hongkou District, Shanghai, China.
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8
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Xie H, Liu Y, Lei H, Song T, Yue G, Du Y, Wang T, Zhang G, Lei B. Adversarial learning-based multi-level dense-transmission knowledge distillation for AP-ROP detection. Med Image Anal 2023; 84:102725. [PMID: 36527770 DOI: 10.1016/j.media.2022.102725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 10/31/2022] [Accepted: 12/02/2022] [Indexed: 12/13/2022]
Abstract
The Aggressive Posterior Retinopathy of Prematurity (AP-ROP) is the major cause of blindness for premature infants. The automatic diagnosis method has become an important tool for detecting AP-ROP. However, most existing automatic diagnosis methods were with heavy complexity, which hinders the development of the detecting devices. Hence, a small network (student network) with a high imitation ability is exactly needed, which can mimic a large network (teacher network) with promising diagnostic performance. Also, if the student network is too small due to the increasing gap between teacher and student networks, the diagnostic performance will drop. To tackle the above issues, we propose a novel adversarial learning-based multi-level dense knowledge distillation method for detecting AP-ROP. Specifically, the pre-trained teacher network is utilized to train multiple intermediate-size networks (i.e., teacher-assistant networks) and one student network by dense transmission mode, where the knowledge from all upper-level networks is transmitted to the current lower-level network. To ensure that two adjacent networks can distill the abundant knowledge, the adversarial learning module is leveraged to enforce the lower-level network to generate the features that are similar to those of the upper-level network. Extensive experiments demonstrate that our proposed method can realize the effective knowledge distillation from the teacher to student networks. We achieve a promising knowledge distillation performance for our private dataset and a public dataset, which can provide a new insight for devising lightweight detecting systems of fundus diseases for practical use.
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Affiliation(s)
- Hai Xie
- National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China
| | - Yaling Liu
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China
| | - Haijun Lei
- Guangdong Province Key Laboratory of Popular High-performance Computers, School of Computer and Software Engineering, Shenzhen University, Shenzhen, China
| | - Tiancheng Song
- Shenzhen Silan Zhichuang Technology Co., Ltd., Shenzhen, China
| | - Guanghui Yue
- National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China
| | - Yueshanyi Du
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China
| | - Tianfu Wang
- National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China
| | - Guoming Zhang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China.
| | - Baiying Lei
- National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China.
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Bujoreanu Bezman L, Tiutiuca C, Totolici G, Carneciu N, Bujoreanu FC, Ciortea DA, Niculet E, Fulga A, Alexandru AM, Stan DJ, Nechita A. Latest Trends in Retinopathy of Prematurity: Research on Risk Factors, Diagnostic Methods and Therapies. Int J Gen Med 2023; 16:937-949. [PMID: 36942030 PMCID: PMC10024537 DOI: 10.2147/ijgm.s401122] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 02/17/2023] [Indexed: 03/15/2023] Open
Abstract
Retinopathy of prematurity (ROP) is a vasoproliferative disorder with an imminent risk of blindness, in cases where early diagnosis and treatment are not performed. The doctors' constant motivation to give these fragile beings a chance at life with optimal visual acuity has never stopped, since Terry first described this condition. Thus, throughout time, several specific advancements have been made in the management of ROP. Apart from the most known risk factors, this narrative review brings to light the latest research about new potential risk factors, such as: proteinuria, insulin-like growth factor 1 (IGF-1) and blood transfusions. Digital imaging has revolutionized the management of retinal pathologies, and it is more and more used in identifying and staging ROP, particularly in the disadvantaged regions by the means of telescreening. Moreover, optical coherence tomography (OCT) and automated diagnostic tools based on deep learning offer new perspectives on the ROP diagnosis. The new therapeutical trend based on the use of anti-VEGF agents is increasingly used in the treatment of ROP patients, and recent research sustains the theory according to which these agents do not interfere with the neurodevelopment of premature babies.
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Affiliation(s)
- Laura Bujoreanu Bezman
- Department of Ophthalmology, “Sfantul Apostol Andrei” Emergency Clinical Hospital, Galati, Romania
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galati, Romania
| | - Carmen Tiutiuca
- Department of Ophthalmology, “Sfantul Apostol Andrei” Emergency Clinical Hospital, Galati, Romania
- Clinical Surgical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galati, Romania
- Correspondence: Carmen Tiutiuca, Clinical Surgical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galati, 800008, Romania, Tel +40741330788, Email
| | - Geanina Totolici
- Department of Ophthalmology, “Sfantul Apostol Andrei” Emergency Clinical Hospital, Galati, Romania
- Clinical Surgical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galati, Romania
| | - Nicoleta Carneciu
- Department of Ophthalmology, “Sfantul Apostol Andrei” Emergency Clinical Hospital, Galati, Romania
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galati, Romania
| | - Florin Ciprian Bujoreanu
- Doctoral School of Biomedical Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galati, Romania
- Florin Ciprian Bujoreanu, Doctoral School of Biomedical Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galati, 800008, Romania, Tel +40741395844, Email
| | - Diana Andreea Ciortea
- Department of Pediatrics, “Sfantul Ioan” Emergency Clinical Hospital for Children, Galati, Romania
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galati, Romania
| | - Elena Niculet
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galati, Romania
- Doctoral School of Biomedical Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galati, Romania
| | - Ana Fulga
- Clinical Surgical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galati, Romania
- Doctoral School of Biomedical Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galati, Romania
| | - Anamaria Madalina Alexandru
- Doctoral School of Biomedical Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galati, Romania
- Department of Neonatology, “Sfantul Apostol Andrei” Emergency Clinical Hospital, Galati, Romania
| | - Daniela Jicman Stan
- Doctoral School of Biomedical Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galati, Romania
| | - Aurel Nechita
- Department of Pediatrics, “Sfantul Ioan” Emergency Clinical Hospital for Children, Galati, Romania
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galati, Romania
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Rasoulinejad SA, Kiyamehr P. The Determinative Role of Cytokines in Retinopathy of Prematurity. Curr Mol Med 2023; 23:36-43. [PMID: 35078395 DOI: 10.2174/1566524022666220117114920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 11/25/2021] [Accepted: 11/30/2021] [Indexed: 12/16/2022]
Abstract
Retinopathy of prematurity (ROP) is a neonatal disease corresponding to vision impairment and blindness. Utilizing the pathogenesis of ROP and the risk factors affecting its progression can help prevent and reduce its incidence and lead to the emergence and development of new treatment strategies. Factors influencing retinopathy include growth and inflammatory factors that play an essential role in the pathogenesis of the ROP. This review summarizes the most critical factors in the pathogenesis of ROP.
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Affiliation(s)
- Seyed Ahmad Rasoulinejad
- Department of Ophthalmology, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Pegah Kiyamehr
- Department of Hematology and Blood Banking, School of Allied Medical Sciences, Iran University of Medical Sciences, Tehran, Iran
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11
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Abdel Aziz I, Alsoda MF, Elmenofy TM, Sakhsoukh MM, Abd el Azim NM, Ahmed AM, Abd El-Halim SA, Baris SSH, Fouad YA, Elghonemy AM, Metwally H, El Gendy WM, Ali R, Basha YM, Mohamed EAE, Amin WM, Naguib MA, Elnashar HA. Tailoring Screening Guidelines for Retinopathy of Prematurity in Egypt: An Exploratory Multicentric Study. Clin Ophthalmol 2022; 16:3625-3630. [PMID: 36348747 PMCID: PMC9637363 DOI: 10.2147/opth.s383497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 10/20/2022] [Indexed: 11/18/2022] Open
Abstract
Background Retinopathy of prematurity (ROP) is increasing in incidence in developing nations, including Egypt. Secondary prevention requires timely detection through the development of regional screening guidelines, which should be preceded by large-scale studies to characterize the population at risk. Methods A prospective, multicentric exploratory study that included five large tertiary institutions in an urban Egyptian setting. All infants born with gestational age (GA) < 37 weeks and/or birth weight (BW) ≤ 2000 grams were screened. More mature and heavier infants with unstable clinical course were also included. The primary outcome measure was the rate of ROP and high-risk disease occurrence in relation to underlying risk factors. Results Of the 768 eyes (384 screened infants), 347 eyes (45.2%) had stage 1 or higher disease, and 43 eyes (5.6%) had high-risk disease. Eyes with stage 1 or higher ROP and treatment-requiring ROP had a mean (± SD) GA of 33.4 (± 2.6) weeks and 32.8 (± 3.2) weeks, and BW of 1842.3 (± 570.1) grams and 1747.6 ± (676.2) grams, respectively. Treatment-requiring eyes belonged to infants that had significantly lower GA and significantly higher prevalence of co-morbidities than non-treatment-requiring eyes. Conclusion The incidence of ROP and high-risk disease in an urban Egyptian setting are similar to those in comparable settings elsewhere and locally. This exploratory study supports tailoring local screening criteria for ROP, and may aid the future development of national guidelines.
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Affiliation(s)
- Ihab Abdel Aziz
- Department of Ophthalmology, The Memorial Institute for Ophthalmic Research, Giza, Egypt
| | - Mohamed Fawzy Alsoda
- Department of Pediatrics and Neonatology, Ahmed Maher Teaching Hospital, Cairo, Egypt
| | - Tarek Mohamed Elmenofy
- Department of Ophthalmology, The Memorial Institute for Ophthalmic Research, Giza, Egypt
| | | | | | - Amr Mahmoud Ahmed
- Department of Ophthalmology, The Memorial Institute for Ophthalmic Research, Giza, Egypt
| | | | | | - Yousef Ahmed Fouad
- Department of Ophthalmology, Ain Shams University Hospitals, Cairo, Egypt
| | | | - Heba Metwally
- Department of Ophthalmology, The Memorial Institute for Ophthalmic Research, Giza, Egypt
| | - Wael Mohamed El Gendy
- Department of Ophthalmology, The Memorial Institute for Ophthalmic Research, Giza, Egypt
| | - Raghdaa Ali
- Department of Pediatrics and Neonatology, Ahmed Maher Teaching Hospital, Cairo, Egypt
| | - Yehia Mahmoud Basha
- Department of Pediatrics and Neonatology, Damanhour Teaching Hospital, Beheira, Egypt
| | | | - Wafaa Mohamed Amin
- Department of Pediatrics and Neonatology, El-Galaa Teaching Hospital, Cairo, Egypt
| | - Maged Adly Naguib
- Department of Ophthalmology, The Memorial Institute for Ophthalmic Research, Giza, Egypt
| | - Hazem Abdallah Elnashar
- Department of Ophthalmology, The Memorial Institute for Ophthalmic Research, Giza, Egypt,Correspondence: Hazem Abdallah Elnashar, Department of Ophthalmology, The Memorial Institute for Ophthalmic Research, Giza, 23314, Egypt, Tel +201227011043, Email
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12
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Research Progress and Potential Applications of Spermidine in Ocular Diseases. Pharmaceutics 2022; 14:pharmaceutics14071500. [PMID: 35890394 PMCID: PMC9323341 DOI: 10.3390/pharmaceutics14071500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 07/04/2022] [Accepted: 07/11/2022] [Indexed: 02/01/2023] Open
Abstract
Spermidine, a natural polyamine, exists in almost all human tissues, exhibiting broad properties like anti-aging, autophagy induction, anti-inflammation, anti-oxidation, cell proliferation activation, and ion channel regulation. Considering that spermidine is already present in human nutrition, recent studies targeting supplementing exogenous sources of this polyamine appear feasible. The protective role of spermidine in various systems has been illuminated in the literature, while recent progress of spermidine administration in ocular diseases remains to be clarified. This study shows the current landscape of studies on spermidine and its potential to become a promising therapeutic agent to treat ocular diseases: glaucoma, optic nerve injury, age-related macular degeneration (AMD), cataracts, dry eye syndrome, and bacterial keratitis. It also has the potential to become a potent biomarker to predict keratoconus (KC), cataracts, uveitis, glaucoma, proliferative diabetic retinopathy (PDR), proliferative vitreoretinopathy (PVR), and retinopathy of prematurity (ROP). We also summarize the routes of administration and the effects of spermidine at different doses.
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13
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Meena S, Bhatnagar K, Sheemar A, Gupta N, Tandon M, Agrawal N. Unmet Need for ROP Screening in Peripheral Rural Areas. Clin Ophthalmol 2022; 16:1963-1969. [PMID: 35733616 PMCID: PMC9208731 DOI: 10.2147/opth.s357591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 05/03/2022] [Indexed: 12/03/2022] Open
Abstract
Aim To study the incidence and risk factors associated with retinopathy of prematurity (ROP) at a tertiary care centre in Western India. Methods A retrospective review of records of both referred and babies born in our hospital who were screened for ROP within the last 21 months at a tertiary care centre was done. The newborns were screened as per National Neonatology Forum of India guidelines. ROP was classified according to the International Classification for Retinopathy of Prematurity criteria. Results A total of 167 neonates were screened with an incidence of ROP of 26.9%. The mean gestational age (GA) and mean birth weight (BW) were 31.89 ± 2.824 weeks and 1538.11 ± 530.84 gm. The mean BW of neonates having any ROP was significantly lower (1296.98gm, p < 0.001), and the mean GA was also significantly lower in ROP babies (30.67 weeks, p < 0.001). O2 supplementation, RDS, IVH, and NEC were the systemic risk factors that significantly correlated with ROP p-value <0.001. On analysis of the correlation of stage of ROP with BW and GA, a significant correlation of −0.307 (p < 0.001) and −0.283 (p < 0.001) was found. Conclusion The incidence of ROP in this study is similar to that reported in the literature from other regions. Other than LBW and GA, oxygen supplementation, RDS, IVH, and NEC were significant risk factors associated with ROP.
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Affiliation(s)
- Seema Meena
- Department of Ophthalmology, AIIMS, Jodhpur, Rajasthan, India
- Correspondence: Seema Meena, Department of Ophthalmology, AIIMS, Jodhpur, Rajasthan, India, Tel +91 9953572984, Email
| | | | | | - Neeraj Gupta
- Department of Ophthalmology, AIIMS, Jodhpur, Rajasthan, India
| | - Manjari Tandon
- Department of Ophthalmology, AIIMS, Jodhpur, Rajasthan, India
| | - Nikhil Agrawal
- Department of Ophthalmology, AIIMS, Jodhpur, Rajasthan, India
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14
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Huang CW, Yeh PT, Tsao PN, Chou HC, Chen CY, Yen TA, Huang HC, Lai TT. Validation of the Postnatal Growth and Retinopathy of Prematurity Screening Criteria in a Taiwanese Cohort. Am J Ophthalmol 2022; 237:22-31. [PMID: 34780799 DOI: 10.1016/j.ajo.2021.11.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 11/04/2021] [Accepted: 11/05/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE To validate the performance of Postnatal Growth and Retinopathy of Prematurity (G-ROP) screening criteria in a Taiwanese cohort. DESIGN Screening evaluation with retrospective data. METHOD Premature infants who underwent retinopathy of prematurity (ROP) screening between January 2015 and April 2019 at a tertiary hospital were examined. Infants with known final ROP results and complete longitudinal weight records were included. G-ROP screening criteria, both original and simplified (G-ROP 180 g), were applied as the prediction model for type 1 ROP; sensitivity and specificity were analyzed. The reduction in the number of infants requiring ROP screening and the number of funduscopic examinations were calculated. RESULT A total of 303 infants with documented ROP outcomes and complete weight gain records were examined. Of these, 103 infants developed ROP, of whom 29 developed type 1 ROP, whereas the other 200 did not develop ROP. For the detection of type 1 ROP, the sensitivity and specificity of the original G-ROP screening criteria were 96.6% and 42.3%, and 100% and 31%, for the simplified G-ROP 180 g model, respectively. The reduction in the number of infants requiring screening and funduscopic examinations was 32.6% and 33.5% for the original G-ROP criteria, and 28.1% and 23.2% for the G-ROP 180 g model, respectively. CONCLUSION Both the original G-ROP and G-ROP 180 g criteria attained high sensitivities in detecting type 1 ROP in the current Taiwanese cohort, with the G-ROP 180-g model outperforming the original one. Validation and modification may be required before applying G-ROP screening criteria to different populations.
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Affiliation(s)
- Ching-Wen Huang
- From the Department of Ophthalmology (C.-W.H., P.-T.Y., T.-T.L.), National Taiwan University Hospital, Taipei, Taiwan
| | - Po-Ting Yeh
- From the Department of Ophthalmology (C.-W.H., P.-T.Y., T.-T.L.), National Taiwan University Hospital, Taipei, Taiwan
| | - Po-Nien Tsao
- Department of Pediatrics (P.-N.T., H.-C.C., C.-Y.C., T.-A.Y., H.-C.H.), National Taiwan University Hospital, Taipei, Taiwan; Research Center for Developmental Biology & Regenerative Medicine (P.-N.T.), National Taiwan University, Taipei, Taiwan
| | - Hung-Chieh Chou
- Department of Pediatrics (P.-N.T., H.-C.C., C.-Y.C., T.-A.Y., H.-C.H.), National Taiwan University Hospital, Taipei, Taiwan
| | - Chien-Yi Chen
- Department of Pediatrics (P.-N.T., H.-C.C., C.-Y.C., T.-A.Y., H.-C.H.), National Taiwan University Hospital, Taipei, Taiwan
| | - Ting-An Yen
- Department of Pediatrics (P.-N.T., H.-C.C., C.-Y.C., T.-A.Y., H.-C.H.), National Taiwan University Hospital, Taipei, Taiwan
| | - Hsin-Chung Huang
- Department of Pediatrics (P.-N.T., H.-C.C., C.-Y.C., T.-A.Y., H.-C.H.), National Taiwan University Hospital, Taipei, Taiwan
| | - Tso-Ting Lai
- From the Department of Ophthalmology (C.-W.H., P.-T.Y., T.-T.L.), National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Clinical Medicine (T.-T.L.), College of Medicine, National Taiwan University, Taipei, Taiwan.
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15
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Tan W, Li B, Wang Z, Zou J, Jia Y, Yoshida S, Zhou Y. Novel Potential Biomarkers for Retinopathy of Prematurity. Front Med (Lausanne) 2022; 9:840030. [PMID: 35187013 PMCID: PMC8848752 DOI: 10.3389/fmed.2022.840030] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 01/12/2022] [Indexed: 12/11/2022] Open
Abstract
Retinopathy of prematurity (ROP) is the main risk factor for vision-threatening disease in premature infants with low birth weight. An accumulating number of independent studies have focused on ROP pathogenesis and have demonstrated that laser photocoagulation therapy and/or anti-VEGF treatment are effective. However, early diagnosis of ROP is still critical. At present, the main method of ROP screening is based on binocular indirect ophthalmoscopy. However, the judgment of whether ROP occurs and whether treatment is necessary depends largely on ophthalmologists with a great deal of experience. Therefore, it is essential to develop a simple, accurate and effective diagnostic method. This review describes recent findings on novel biomarkers for the prediction, diagnosis and prognosis of ROP patients. The novel biomarkers were separated into the following categories: metabolites, cytokines and growth factors, non-coding RNAs, iconography, gut microbiota, oxidative stress biomarkers, and others. Biomarkers with high sensitivity and specificity are urgently needed for the clinical applications of ROP. In addition, using non-invasive or minimally invasive methods to obtain samples is also important. Our review provides an overview of potential biomarkers of ROP.
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Affiliation(s)
- Wei Tan
- Department of Ophthalmology, The Second Xiangya Hospital of Central South University, Changsha, China.,Hunan Clinical Research Center of Ophthalmic Disease, Changsha, China
| | - Bingyan Li
- Department of Ophthalmology, The Second Xiangya Hospital of Central South University, Changsha, China.,Hunan Clinical Research Center of Ophthalmic Disease, Changsha, China
| | - Zicong Wang
- Department of Ophthalmology, The Second Xiangya Hospital of Central South University, Changsha, China.,Hunan Clinical Research Center of Ophthalmic Disease, Changsha, China
| | - Jingling Zou
- Department of Ophthalmology, The Second Xiangya Hospital of Central South University, Changsha, China.,Hunan Clinical Research Center of Ophthalmic Disease, Changsha, China
| | - Yang Jia
- Department of Pediatrics, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Shigeo Yoshida
- Department of Ophthalmology, Kurume University School of Medicine, Kurume, Japan
| | - Yedi Zhou
- Department of Ophthalmology, The Second Xiangya Hospital of Central South University, Changsha, China.,Hunan Clinical Research Center of Ophthalmic Disease, Changsha, China
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16
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Filippi L, Cammalleri M, Amato R, Ciantelli M, Pini A, Bagnoli P, Dal Monte M. Decoupling Oxygen Tension From Retinal Vascularization as a New Perspective for Management of Retinopathy of Prematurity. New Opportunities From β-adrenoceptors. Front Pharmacol 2022; 13:835771. [PMID: 35126166 PMCID: PMC8814365 DOI: 10.3389/fphar.2022.835771] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 01/05/2022] [Indexed: 12/20/2022] Open
Abstract
Retinopathy of prematurity (ROP) is an evolutive and potentially blinding eye disease that affects preterm newborns. Unfortunately, until now no conservative therapy of active ROP with proven efficacy is available. Although ROP is a multifactorial disease, premature exposition to oxygen concentrations higher than those intrauterine, represents the initial pathogenetic trigger. The increase of oxygenation in a retina still incompletely vascularized promotes the downregulation of proangiogenic factors and finally the interruption of vascularization (ischemic phase). However, the increasing metabolic requirement of the ischemic retina induces, over the following weeks, a progressive hypoxia that specularly increases the levels of proangiogenic factors finally leading to proliferative retinopathy (proliferative phase). Considering non-modifiable the coupling between oxygen levels and vascularization, so far, neonatologists and ophthalmologists have “played defense”, meticulously searching the minimum necessary concentration of oxygen for individual newborns, refining their diagnostic ability, adopting a careful monitoring policy, ready to decisively intervene only in a very advanced stage of disease progression. However, recent advances have demonstrated the possibility to pharmacologically modulate the relationship between oxygen and vascularization, opening thus the perspective for new therapeutic or preventive opportunities. The perspective of a shift from a defensive towards an attack strategy is now at hand.
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Affiliation(s)
- Luca Filippi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- *Correspondence: Luca Filippi,
| | | | - Rosario Amato
- Department of Biology, University of Pisa, Pisa, Italy
| | | | - Alessandro Pini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Paola Bagnoli
- Department of Biology, University of Pisa, Pisa, Italy
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17
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Tsai AS, Chou HD, Ling XC, Al-Khaled T, Valikodath N, Cole E, Yap VL, Chiang MF, Chan RVP, Wu WC. Assessment and management of retinopathy of prematurity in the era of anti-vascular endothelial growth factor (VEGF). Prog Retin Eye Res 2021; 88:101018. [PMID: 34763060 DOI: 10.1016/j.preteyeres.2021.101018] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 10/27/2021] [Accepted: 10/29/2021] [Indexed: 02/06/2023]
Abstract
The incidence of retinopathy of prematurity (ROP) continues to rise due to the improved survival of very low birth weight infants in developed countries. This epidemic is also fueled by increased survival of preterm babies with variable use of oxygen and a lack of ROP awareness and screening services in resource-limited regions. Improvements in technology and a basic understanding of the disease pathophysiology have changed the way we screen and manage ROP, educate providers and patients, and improve ROP awareness. Advancements in imaging techniques, expansion of telemedicine services, and the potential for artificial intelligence-assisted ROP screening programs have created opportunities to improve ROP care in areas with a shortage of ophthalmologists trained in ROP. To address the gap in provider knowledge regarding ROP, the Global Education Network for Retinopathy of Prematurity (GEN-ROP) created a web-based tele-education training module that can be used to educate all providers involved in ROP, including non-physician ROP screeners. Over the past 50 years, the treatment of severe ROP has evolved from limited treatment modalities to cryotherapy and laser photocoagulation. More recently, there has been growing evidence to support the use of anti-vascular endothelial growth factor (VEGF) agents for the treatment of severe ROP. However, VEGF is known to be important in organogenesis and microvascular maintenance, and given that intravitreal anti-VEGF treatment can result in systemic VEGF suppression over a period of at least 1-12 weeks, there are concerns regarding adverse effects and long-term ocular and systemic developmental consequences of anti-VEGF therapy. Future research in ophthalmology to address the growing burden of ROP should focus on cost-effective fundus imaging devices, implementation of artificial intelligence platforms, updated treatment algorithms with optimal use of anti-VEGF and careful investigation of its long-term effects, and surgical options in advanced ROP. Addressing these unmet needs will aid the global effort against the ROP epidemic and optimize our understanding and treatment of this blinding disease.
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Affiliation(s)
- Andrew Sh Tsai
- Singapore National Eye Centre, Singapore; DUKE NUS Medical School, Singapore
| | - Hung-Da Chou
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Xiao Chun Ling
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Tala Al-Khaled
- Department of Ophthalmology & Visual Sciences, University of Illinois at Chicago, Illinois Eye and Ear Infirmary, Chicago, IL, USA
| | - Nita Valikodath
- Department of Ophthalmology & Visual Sciences, University of Illinois at Chicago, Illinois Eye and Ear Infirmary, Chicago, IL, USA
| | - Emily Cole
- Department of Ophthalmology & Visual Sciences, University of Illinois at Chicago, Illinois Eye and Ear Infirmary, Chicago, IL, USA
| | - Vivien L Yap
- Division of Newborn Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Michael F Chiang
- National Eye Institute, National Institutes of Health, Bethesda, MD, USA
| | - R V Paul Chan
- Department of Ophthalmology & Visual Sciences, University of Illinois at Chicago, Illinois Eye and Ear Infirmary, Chicago, IL, USA.
| | - Wei-Chi Wu
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
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18
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Preterm refraction and ocular biometry in children with and without retinopathy of prematurity in the first year of life. J AAPOS 2021; 25:271.e1-271.e6. [PMID: 34582950 DOI: 10.1016/j.jaapos.2021.05.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 04/30/2021] [Accepted: 05/02/2021] [Indexed: 11/21/2022]
Abstract
PURPOSE To determine ocular biometric and refractive profiles of premature children at risk of retinopathy of prematurity (ROP), comparing those who did and did not require laser treatment. METHODS In this prospective study, premature infants underwent biometry and refraction with their first ROP examination. Study parameters were assessed again at 3 months, 6 months, and 1 year. The main outcome measures were spherical equivalent, axial length, and keratometry. RESULTS A total of 122 infants (243 eyes) were included. At baseline, infants without ROP, those with ROP who never needed treatment, and those who later needed treatment had overall comparable axial length (P = 0.53) and myopia (P = 0.05); the highest severity group had higher corneal steepness and more myopia at baseline. At 1 year, children with laser-treated ROP had the shortest axial lengths, with the least decrease in keratometry, and the greatest increase in myopia (-2.0 D; P = 0.001). Anisometropia, if present initially, persisted through the 1-year examination. Mean refractive error was more myopic in zone 1 disease (P = 0.3) and in aggressive posterior ROP (P = 0.15). CONCLUSIONS Severe ROP is associated with disruption of emmetropization, and steeper corneas and more myopia at the first ROP examination, before any intervention. In our study cohort, these differences became more marked over the course of 1 year after laser therapy. The myopia in these cases was not axial. Laser therapy did not induce new anisometropia.
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19
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Li X, Cai S, He Z, Reilly J, Zeng Z, Strang N, Shu X. Metabolomics in Retinal Diseases: An Update. BIOLOGY 2021; 10:944. [PMID: 34681043 PMCID: PMC8533136 DOI: 10.3390/biology10100944] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 09/16/2021] [Accepted: 09/18/2021] [Indexed: 12/17/2022]
Abstract
Retinal diseases are a leading cause of visual loss and blindness, affecting a significant proportion of the population worldwide and having a detrimental impact on quality of life, with consequent economic burden. The retina is highly metabolically active, and a number of retinal diseases are associated with metabolic dysfunction. To better understand the pathogenesis underlying such retinopathies, new technology has been developed to elucidate the mechanism behind retinal diseases. Metabolomics is a relatively new "omics" technology, which has developed subsequent to genomics, transcriptomics, and proteomics. This new technology can provide qualitative and quantitative information about low-molecular-weight metabolites (M.W. < 1500 Da) in a given biological system, which shed light on the physiological or pathological state of a cell or tissue sample at a particular time point. In this article we provide an extensive review of the application of metabolomics to retinal diseases, with focus on age-related macular degeneration (AMD), diabetic retinopathy (DR), retinopathy of prematurity (ROP), glaucoma, and retinitis pigmentosa (RP).
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Affiliation(s)
- Xing Li
- School of Basic Medical Sciences, Shaoyang University, Shaoyang 422000, China; (X.L.); (Z.H.)
| | - Shichang Cai
- Department of Human Anatomy, School of Medicine, Hunan University of Medicine, Huaihua 418000, China;
| | - Zhiming He
- School of Basic Medical Sciences, Shaoyang University, Shaoyang 422000, China; (X.L.); (Z.H.)
| | - James Reilly
- Department of Biological and Biomedical Sciences, Glasgow Caledonian University, Glasgow G4 0BA, UK;
| | - Zhihong Zeng
- College of Biological and Environmental Engineering, Changsha University, Changsha 410022, China;
| | - Niall Strang
- Department of Vision Science, Glasgow Caledonian University, Glasgow G4 0BA, UK;
| | - Xinhua Shu
- School of Basic Medical Sciences, Shaoyang University, Shaoyang 422000, China; (X.L.); (Z.H.)
- Department of Biological and Biomedical Sciences, Glasgow Caledonian University, Glasgow G4 0BA, UK;
- Department of Vision Science, Glasgow Caledonian University, Glasgow G4 0BA, UK;
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20
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Hong Y, Luo Y. Zebrafish Model in Ophthalmology to Study Disease Mechanism and Drug Discovery. Pharmaceuticals (Basel) 2021; 14:ph14080716. [PMID: 34451814 PMCID: PMC8400593 DOI: 10.3390/ph14080716] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/16/2021] [Accepted: 07/21/2021] [Indexed: 12/14/2022] Open
Abstract
Visual impairment and blindness are common and seriously affect people’s work and quality of life in the world. Therefore, the effective therapies for eye diseases are of high priority. Zebrafish (Danio rerio) is an alternative vertebrate model as a useful tool for the mechanism elucidation and drug discovery of various eye disorders, such as cataracts, glaucoma, diabetic retinopathy, age-related macular degeneration, photoreceptor degeneration, etc. The genetic and embryonic accessibility of zebrafish in combination with a behavioral assessment of visual function has made it a very popular model in ophthalmology. Zebrafish has also been widely used in ocular drug discovery, such as the screening of new anti-angiogenic compounds or neuroprotective drugs, and the oculotoxicity test. In this review, we summarized the applications of zebrafish as the models of eye disorders to study disease mechanism and investigate novel drug treatments.
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Affiliation(s)
| | - Yan Luo
- Correspondence: ; Tel.: +86-020-87335931
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21
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Olivieri DJ, Yu ZZ, Greenberg PB. Characteristics of ophthalmic grants to low- and middle-income countries. Graefes Arch Clin Exp Ophthalmol 2021; 259:3185-3187. [PMID: 34151382 DOI: 10.1007/s00417-021-05242-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/04/2021] [Accepted: 05/11/2021] [Indexed: 11/28/2022] Open
Affiliation(s)
- Daniel J Olivieri
- Division of Ophthalmology, Alpert Medical School, Brown University, Coro Center West, Suite 200, 1 Hoppin Street, Providence, RI, USA.,Section of Ophthalmology, Providence VA Medical Center, Providence, RI, USA.,Watson Institute for International and Public Affairs, Brown University, Providence, RI, USA
| | - Zane Z Yu
- Division of Ophthalmology, Alpert Medical School, Brown University, Coro Center West, Suite 200, 1 Hoppin Street, Providence, RI, USA
| | - Paul B Greenberg
- Division of Ophthalmology, Alpert Medical School, Brown University, Coro Center West, Suite 200, 1 Hoppin Street, Providence, RI, USA. .,Section of Ophthalmology, Providence VA Medical Center, Providence, RI, USA.
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22
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The Nrf2 inhibitor brusatol has a protective role in a rat model of oxygen-induced retinopathy of prematurity. Vis Neurosci 2021; 38:E002. [PMID: 33729121 DOI: 10.1017/s095252382100002x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Nuclear factor-erythroid 2-related factor 2 (Nrf2) has been testified to be involved in the development of retinopathy of prematurity (ROP), which can cause childhood visual impairment. Whether brusatol, an Nrf2 inhibitor, could be utilized to treat ROP was unknown. The oxygen-induced retinopathy rat model was established to mimic ROP, which was further intravitreal administrated with brusatol. Vessel morphology and microglial activation in the retina were assessed with histology analysis. The relative expression levels of angiogenesis and inflammation-related molecules were detected with Western blot and real-time polymerase chain reaction methods. Intravitreal brusatol administration could alleviate both angiogenesis and microgliosis induced by hyperoxia, along with down-regulation of vascular endothelial growth factor, vascular endothelial growth factor receptor (VEGFR)-1, VEGFR-2, cluster of differentiation molecule 11B, tumor necrosis factor alpha, inducible nitric oxide synthase, glial fibrillary acidic protein, and IBA-1 expression. It was further revealed that Nrf2 and heme oxygenease-1 were diminished by brusatol administration. The results demonstrate the potential of intravitreal brusatol deliver to treat ROP with down-regulation of angiogenesis and microgliosis.
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Sen P, Jaichandran VV, Sreenivasan J. Aerosol containment box for laser treatment of retinopathy of prematurity in COVID-19 pandemic. Indian J Ophthalmol 2021; 69:743-745. [PMID: 33595516 PMCID: PMC7942090 DOI: 10.4103/ijo.ijo_3155_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Type 1 retinopathy of prematurity (ROP) requires emergency intervention and laser is an established modality of treatment. Laser treatment for ROP under topical anesthesia can be considered as an aerosol-generating procedure due to crying that puts health care workers at high risk of COVID-19 transmission. Aerosol containment box (ACB) is known to minimize aerosol transmission and there are reports of ROP laser done through incubator. Combining these two ideas, we describe a new application of ACB with suction for laser treatment of ROP thereby, reducing risk to health care team without compromising timely effective, and safe treatment for ROP.
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Affiliation(s)
- Parveen Sen
- Shri Bhagwan Mahavir Vitreoretinal Services, Medical Research Foundation, Sankara Nethralaya, Nungambakkam, Chennai, Tamil Nadu, India
| | - V V Jaichandran
- Department of Anaesthesiology, Medical Research Foundation, Sankara Nethralaya, Nungambakkam, Chennai, Tamil Nadu, India
| | - Janani Sreenivasan
- Shri Bhagwan Mahavir Vitreoretinal Services, Medical Research Foundation, Sankara Nethralaya, Nungambakkam, Chennai, Tamil Nadu, India
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Vinekar A, Nair AP, Sinha S, Vaidya T, Chakrabarty K, Shetty R, Ghosh A, Sethu S. Tear Fluid Angiogenic Factors: Potential Noninvasive Biomarkers for Retinopathy of Prematurity Screening in Preterm Infants. Invest Ophthalmol Vis Sci 2021; 62:2. [PMID: 33646290 PMCID: PMC7938022 DOI: 10.1167/iovs.62.3.2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Purpose To determine the status of proangiogenic factors in the tear fluid of preterm infants with and without retinopathy of prematurity (ROP). Methods Preterm infants (n = 36) undergoing routine ROP screening included in the prospective study were categorized as No-ROP (n = 13, no ROP at any visits), ROP (if ROP was present at first visit; n = 18), or No-ROP to ROP (no disease at first visit, but developed ROP subsequently; n = 5). Infants with ROP were also grouped as progressing (n = 7) and regressing (n = 16) based on ROP evolution between the first and subsequent visits. Schirmer's strips were used to collect tear fluid and proangiogenic factors (VEGF, angiogenin, soluble vascular cell adhesion molecule, and fractalkine) levels (in picograms per milliliter) in tear fluid were measured by multiplex ELISA. Results Lower levels of VEGF (135 ± 69; mean ± standard deviation) and higher levels of angiogenin (6568 ± 4975) were observed in infants with ROP compared with infants without ROP (172.5 ± 54.0; 4139 ± 3909) at the first visit. Significantly lower levels of VEGF were observed in the No-ROP to ROP group compared with the No-ROP and ROP groups. The VEGF and angiogenin levels at the first visit were significantly lower in infants with ROP with progressing disease. Angiogenin levels negatively correlated with birth weight and gestational age in ROP. The area under the curve (AUC) and odds ratio (OR) analysis demonstrated that angiogenin/birth weight (AUC = 0.776; OR, 8.6); angiogenin/gestational age (AUC = 0.706; OR, 7.3) and Angiogenin/VEGF (AUC = 0.806; OR, 14.3) ratios were able to differentiated preterm infants with and without ROP. Conclusions The association between angiogenin and ROP suggests its possible role in ROP. The ratio of angiogenin level with birth weight, gestational age, and/or VEGF could serve as a potential noninvasive screening biomarker for ROP.
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Affiliation(s)
- Anand Vinekar
- Department of Pediatric Retina, Narayana Nethralaya, Bangalore, India
| | - Archana Padmanabhan Nair
- GROW Research Lab, Narayana Nethralaya Foundation, Bangalore, India.,Manipal Academy of Higher Education, Manipal, India
| | - Shivani Sinha
- Department of Pediatric Retina, Narayana Nethralaya, Bangalore, India
| | - Tanuja Vaidya
- GROW Research Lab, Narayana Nethralaya Foundation, Bangalore, India.,Manipal Academy of Higher Education, Manipal, India
| | | | - Rohit Shetty
- Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bangalore, India
| | - Arkasubhra Ghosh
- GROW Research Lab, Narayana Nethralaya Foundation, Bangalore, India.,Singapore Eye Research Institute, Singapore
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Aritonang C. Low Vision Management in A 5-Years-Old Due to Retinopathy of Prematurity for Life Quality Improvement. FOLIA MEDICA INDONESIANA 2021. [DOI: 10.20473/fmi.v56i4.24649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction: Management of low vision in pediatric patients with greater result can affect their quality of life than in adult low vision patients.. Retinopathy of Prematurity is the main cause of blindness in children. A case study highlights the tertiary prevention (low vision examination and management) in a 5 year old boy with ROP related blindness to optimize his remaining visual capacity by using optical and non optical aids that support daily activity and educational learning.Case Report: A 5 year old boy with ROP related blindness visited to the low vision clinic after receiving the several treatments for ROP before. His visual acuities were light perception in the right eye and hand movement in the left eye using his current spectacle correction. He had anti VEGF bevacizumab intravitreal injection, vitrectomy and complicated cataract extraction history on the left eye. He wasdifficult to learn and read numbers and alphabets caused by visual impairment.Discussion : Upon evaluation by assessment low vision method, his distance visual acuity in the left eye was improved significantly up to 3/40 on LEA Acuity chart with +14.00D. His near vision became 10 M at 30 cm of reading distance (without near correction) and 4 M at 13 cm improved with +3.00 D by spectacle. The non optical aid devices as reading task were also suggested to improove continuous reading text without difficulty.Conclusion: ROP blindness can be preventable if appropriate, adequate and accessible screening programmes are available. Unfortunately, even with the current screening guidelines and recommended treatment of ROP, many babies suffer from blindness by this disease each year. Low vision assessment and management in pediatric patient with visual impairmentaccording to children’s need can optimize the recent visual capability of low vision patient and give self care daily activity and educational learning.
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Azad R, Gilbert C, Gangwe AB, Zhao P, Wu WC, Sarbajna P, Vinekar A. Retinopathy of Prematurity: How to Prevent the Third Epidemics in Developing Countries. Asia Pac J Ophthalmol (Phila) 2020; 9:440-448. [PMID: 32925293 DOI: 10.1097/apo.0000000000000313] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Retinopathy of prematurity (ROP) is vasoproliferative disease affecting preterm infants and is a leading cause of avoidable childhood blindness worldwide. The world is currently experiencing the third epidemic of ROP, where majority of the cases are from middle-income countries. Over 40% of the world's premature infants were born in India, China, Bangladesh, Pakistan, and Indonesia. Together with other neighboring nations, this region has unique challenges in ROP management. Key aspects of the challenges including heavier and more mature infants developing severe ROP. Current strategies include adoption of national screening guidelines, telemedicine, integrating vision rehabilitation and software innovations in the form of artificial intelligence. This review overviews some of these aspects.
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Affiliation(s)
- Rajvardhan Azad
- Regional institute of Ophthalmology, Indira Gandhi institute of Medical Sciences, Patna, Bihar, India
| | - Claire Gilbert
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | - Peiquan Zhao
- Department of Ophthalmology, Xinhua Hospital, affiliated to Shanghai Jiaotong, University School of Medicine, Shanghai, China
| | - Wei-Chi Wu
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Williams LB, Prakalapakorn SG, Ansari Z, Goldhardt R. Impact and Trends in Global Ophthalmology. CURRENT OPHTHALMOLOGY REPORTS 2020; 8:136-143. [PMID: 32837802 PMCID: PMC7306491 DOI: 10.1007/s40135-020-00245-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Purpose of Review Our goal is to provide a review of the impact, global estimates, and projection of vision impairment as well as ongoing systems for eye care delivery. Recent Findings Many of the blinding diseases in developing countries are preventable or curable, but the lack of ophthalmologists, the lack of education, and the lack of access to any eye care are some of the major obstacles encountered. Summary As our world becomes more interconnected through globalization, the interactions between different cultures and populations increase. Global ophthalmology is a field dedicated to building sustainable eye care delivery systems to deliver high-quality care in minimal resource settings, with the aim of reducing blindness around the world.
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Affiliation(s)
- Lloyd B Williams
- Department of Ophthalmology, Duke University, Durham, NC USA.,Duke Global Health Institute, Duke University, Durham, NC USA
| | - S Grace Prakalapakorn
- Department of Ophthalmology, Duke University, Durham, NC USA.,Duke Global Health Institute, Duke University, Durham, NC USA.,Department of Pediatrics, Duke University, Durham, NC USA
| | - Zubair Ansari
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17th St, Office #275, Miami, FL 33136 USA
| | - Raquel Goldhardt
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17th St, Office #275, Miami, FL 33136 USA
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