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Downes RA, Rachitskaya AV. Ophthalmic sequelae of prematurity in late childhood and adulthood: A review. Clin Exp Ophthalmol 2024; 52:355-364. [PMID: 38334000 DOI: 10.1111/ceo.14358] [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: 08/31/2023] [Revised: 12/07/2023] [Accepted: 01/03/2024] [Indexed: 02/10/2024]
Abstract
Advances in the care of premature infants have resulted in unprecedented rates of survival of these infants into adulthood, including those born at very low gestational ages. Ophthalmologists have historically followed premature infants to assess for the presence of and potential need for treatment of retinopathy of prematurity. However, a growing body of literature suggests that the ophthalmic consequences of prematurity extended beyond retinopathy of prematurity and that ophthalmic sequelae of prematurity can endure through adulthood even among formerly preterm adults who were never diagnosed with retinopathy of prematurity. These abnormalities can include a range of both anterior segment and posterior segment sequelae, including higher rates of corneal aberrations, ocular hypertension, strabismus, foveal anomalies, and retinal tears and detachments. This review aims to summarise this literature, underscoring the importance of lifelong examinations and regular monitoring for these complications among adults who were born prematurely.
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Affiliation(s)
- Rachel A Downes
- Vitreoretinal Service, Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
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Aakvik KAD, Benum SD, Tikanmäki M, Hovi P, Räikkönen K, Harris SL, Woodward LJ, Darlow BA, Indredavik MS, Lydersen S, Mork PJ, Kajantie E, Evensen KAI. Physical activity and cognitive function in adults born very preterm or with very low birth weight-an individual participant data meta-analysis. PLoS One 2024; 19:e0298311. [PMID: 38349926 PMCID: PMC10863878 DOI: 10.1371/journal.pone.0298311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 12/30/2023] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVE Individuals born very preterm (<32 weeks of gestation) or with very low birthweight (<1500g) have lower cognitive function compared with term-born peers. Furthermore, some studies suggest that they are less physically active as young adults than controls, but the relationship between physical activity and cognitive function remains unclear. We performed an individual participant data meta-analysis to examine whether being born preterm/with very low birth weight is associated with physical activity in adulthood and examined if cognitive function mediates this association. STUDY DESIGN Cohorts with data on physical activity and cognitive function in adults born very preterm/very low birth weight and term-born controls were recruited from the Research on European Children and Adults Born Preterm, and the Adults Born Preterm International Collaboration Consortia. A systematic literature search was performed in PubMed and Embase. RESULTS Five cohorts with 1644 participants aged 22-28 years (595 very preterm/very low birth weight and 1049 controls) were included. Adults born very preterm/very low birth weight reported 1.11 (95% CI: 0.68 to 1.54) hours less moderate to vigorous physical activity per week than controls, adjusted for cohort, age and sex. The difference between individuals born very preterm/very low birth weight and controls was larger among women than among men. Neither intelligence quotient nor self-reported executive function mediated the association between very preterm/very low birth weight and moderate to vigorous physical activity. Results were essentially the same when we excluded individuals with neurosensory impairments. CONCLUSION Adults born very preterm/very low birth weight, especially women, reported less moderate to vigorous physical activity than their term-born peers. Cognitive function did not mediate this association. Considering the risk of adverse health outcomes among individuals born preterm, physical activity could be a target for intervention.
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Affiliation(s)
- Kristina Anna Djupvik Aakvik
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Silje Dahl Benum
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Marjaana Tikanmäki
- Clinical Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Public Health Unit, Finnish Institute for Health and Welfare, Helsinki/Oulu, Finland
| | - Petteri Hovi
- Public Health Unit, Finnish Institute for Health and Welfare, Helsinki/Oulu, Finland
- Children’s Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Katri Räikkönen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Sarah L. Harris
- Department of Paediatrics, University of Otago Christchurch, Christchurch, New Zealand
| | - Lianne J. Woodward
- School of Health Sciences, University of Canterbury, Christchurch, New Zealand
| | - Brian A. Darlow
- Department of Paediatrics, University of Otago Christchurch, Christchurch, New Zealand
| | - Marit S. Indredavik
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Stian Lydersen
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Paul Jarle Mork
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Eero Kajantie
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Clinical Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Public Health Unit, Finnish Institute for Health and Welfare, Helsinki/Oulu, Finland
- Children’s Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Kari Anne I. Evensen
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
- Unit for Physiotherapy Services, Trondheim Municipality, Trondheim, Norway
- Children’s Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
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3
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Ingvaldsen SH, Jørgensen AP, Grøtting A, Sand T, Eikenes L, Håberg AK, Indredavik MS, Lydersen S, Austeng D, Morken TS, Evensen KAI. Visual outcomes and their association with grey and white matter microstructure in adults born preterm with very low birth weight. Sci Rep 2024; 14:2624. [PMID: 38297018 PMCID: PMC10831077 DOI: 10.1038/s41598-024-52836-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 01/24/2024] [Indexed: 02/02/2024] Open
Abstract
Individuals born with very low birth weight (VLBW; < 1500 g) have a higher risk of reduced visual function and brain alterations. In a longitudinal cohort study, we assessed differences in visual outcomes and diffusion metrics from diffusion tensor imaging (DTI) at 3 tesla in the visual white matter pathway and primary visual cortex at age 26 in VLBW adults versus controls and explored whether DTI metrics at 26 years was associated with visual outcomes at 32 years. Thirty-three VLBW adults and 50 term-born controls was included in the study. Visual outcomes included best corrected visual acuity, contrast sensitivity, P100 latency, and retinal nerve fibre layer thickness. Mean diffusivity, axial diffusivity, radial diffusivity, and fractional anisotropy was extracted from seven regions of interest in the visual pathway: splenium, genu, and body of corpus callosum, optic radiations, lateral geniculate nucleus, inferior-fronto occipital fasciculus, and primary visual cortex. On average the VLBW group had lower contrast sensitivity, a thicker retinal nerve fibre layer and higher axial diffusivity and radial diffusivity in genu of corpus callosum and higher radial diffusivity in optic radiations than the control group. Higher fractional anisotropy in corpus callosum areas were associated with better visual function in the VLBW group but not the control group.
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Affiliation(s)
- Sigrid Hegna Ingvaldsen
- Department of Neuromedicine and Movement Science, NTNU Norwegian University of Science and Technology, Trondheim, Norway.
- Department of Ophthalmology, St. Olav Hospital, Trondheim University Hospital, Trondheim, Norway.
| | - Anna Perregaard Jørgensen
- Department of Neuromedicine and Movement Science, NTNU Norwegian University of Science and Technology, Trondheim, Norway
| | - Arnstein Grøtting
- Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Trond Sand
- Department of Neuromedicine and Movement Science, NTNU Norwegian University of Science and Technology, Trondheim, Norway
- Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- NorHEAD - Norwegian Centre for Headache Research, Department of Neuromedicine and Movement Science, NTNU Norwegian University of Science and Technology, Trondheim, Norway
| | - Live Eikenes
- Department of Radiology and Nuclear Medicine, MR-Center, Trondheim University Hospital, Trondheim, Norway
| | - Asta K Håberg
- Department of Neuromedicine and Movement Science, NTNU Norwegian University of Science and Technology, Trondheim, Norway
- Department of Radiology and Nuclear Medicine, MR-Center, Trondheim University Hospital, Trondheim, Norway
| | - Marit S Indredavik
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Stian Lydersen
- Regional Centre for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Dordi Austeng
- Department of Neuromedicine and Movement Science, NTNU Norwegian University of Science and Technology, Trondheim, Norway
- Department of Ophthalmology, St. Olav Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Tora Sund Morken
- Department of Neuromedicine and Movement Science, NTNU Norwegian University of Science and Technology, Trondheim, Norway
- Department of Ophthalmology, St. Olav Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Kari Anne I Evensen
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
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Kulmala M, Jørgensen APM, Aakvik KAD, Jussinniemi L, Benum SD, Ingvaldsen SH, Austeng D, Kajantie E, Evensen KAI, Majander A, Morken TS. Visual function in adults born preterm with very low birth weight-A two-country birth cohort study. Acta Ophthalmol 2024; 102:49-57. [PMID: 37172142 DOI: 10.1111/aos.15683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/17/2023] [Accepted: 04/21/2023] [Indexed: 05/14/2023]
Abstract
PURPOSE The purpose of the study was to investigate visual function and vision-related general health in adults that were born preterm with very low birth weight (VLBW: birth weight < 1500 g) in their 30s-40s. METHODS We recruited 137 adults born preterm with VLBW and 158 term-born controls aged 31-43 years from two birth cohorts: the Helsinki Study of Very Low Birth Weight Adults (Finland) and the NTNU Low Birth Weight in a Lifetime Perspective study (Norway). We used neonatal data and measured refraction, best-corrected visual acuity (BCVA) using the Early Treatment Diabetic Retinopathy Study (ETDRS) chart, contrast sensitivity, visual fields, intraocular pressure (IOP), self-reported vision-targeted health status with the National Eye Institute Visual Function Questionnaire-25. RESULTS VLBW adults had a lower BCVA ETDRS score than controls: mean (SD) better eye 86.7 (13.4) versus 90.2 (4.4), p = 0.02; mean (SD) worse eye 82.3 (14.9) versus 87.6 (4.6), p = 0.003. VLBW adults also had lower contrast sensitivity thresholds in several spatial frequencies and scored lower than controls in eight out of the 12 subscales of self-reported vision-targeted health status. Refraction, visual fields and IOP were similar between groups. Two VLBW participants were blind. None had been treated for retinopathy of prematurity. CONCLUSION We suggest that lower visual function and vision-related health represent life-long consequences of prematurity and VLBW in the studied 31- to 43-year-old cohort. The underlying mechanisms remain to be determined.
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Affiliation(s)
- Maarit Kulmala
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Ophthalmology, Helsinki University Hospital, Helsinki, Finland
| | | | | | - Laura Jussinniemi
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Population Health Unit, Finnish Institute for Health and Welfare, Oulu, Finland
| | - Silje Dahl Benum
- Department of Clinical and Molecular Medicine, NTNU, Trondheim, Norway
| | - Sigrid Hegna Ingvaldsen
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Ophthalmology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Dordi Austeng
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Ophthalmology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Eero Kajantie
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Clinical and Molecular Medicine, NTNU, Trondheim, Norway
- PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Population Health Unit, Finnish Institute for Health and Welfare, Oulu, Finland
- Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Kari Anne I Evensen
- Department of Clinical and Molecular Medicine, NTNU, Trondheim, Norway
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
- Children's Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Anna Majander
- Department of Ophthalmology, Helsinki University Hospital, Helsinki, Finland
- University of Helsinki, Helsinki, Finland
| | - Tora Sund Morken
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Ophthalmology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
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Chen S, Zhang J, Sun D, Wu Y, Fang J, Wan X, Li S, Zhang S, Gu Q, Shao Q, Dong J, Xu X, Wei F, Sun Q. SYVN1 Promotes STAT3 Protein Ubiquitination and Exerts Antiangiogenesis Effects in Retinopathy of Prematurity Development. Invest Ophthalmol Vis Sci 2023; 64:8. [PMID: 37540175 PMCID: PMC10408771 DOI: 10.1167/iovs.64.11.8] [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: 03/13/2023] [Accepted: 07/17/2023] [Indexed: 08/05/2023] Open
Abstract
PURPOSE SYVN1, a gene involved in endoplasmic reticulum-associated degradation, has been found to exert a protective effect by inhibiting inflammation in retinopathy. This study aimed to clarify whether SYVN1 is involved in the pathogenesis of retinopathy of prematurity (ROP) and its potential as a candidate for target therapy. METHODS Human retinal microvascular endothelial cells (hRMECs) and a mouse model of oxygen-induced retinopathy (OIR) were used to reveal the retinopathy development-associated protein expression and molecular mechanism. An adenovirus overexpressing SYVN1 or vehicle control was injected intravitreally at postnatal day 12 (P12), and the neovascular lesions were evaluated in retinal flatmounts with immunofluorescence staining, and hematoxylin and eosin staining at P17. Visual function was assessed by using electroretinogram (ERG). RESULTS Endogenous SYVN1 expression dramatically decreased in hRMECs under hypoxia and in ROP mouse retinas. SYVN1 regulated the signal transducer and activator of transcription 3 (STAT3)/vascular endothelial growth factor (VEGF) axis. SYVN1 overexpression promoted ubiquitination and degradation of STAT3, decreased the levels of phospho-STAT3, secretion of VEGF, and formation of neovascularization in hRMECs, which could be rescued by STAT3 activator treatment. In addition, SYVN1 overexpression prevented neovascularization and extended physiologic retinal vascular development in the retinal tissues of OIR mice without affecting retinal function. CONCLUSIONS SYVN1 has a protective effect against OIR, and the molecular mechanisms are partly through SYVN1-mediated ubiquitination of STAT3 and the subsequent downregulation of VEGF. These findings strongly support our assumption that SYVN1 confers ROP resistance and may be a potentially novel pharmaceutical target against proliferative retinopathy.
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Affiliation(s)
- Shimei Chen
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, National Clinical Research Center for Eye Diseases, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Jian Zhang
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, National Clinical Research Center for Eye Diseases, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Dandan Sun
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, National Clinical Research Center for Eye Diseases, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Yidong Wu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, National Clinical Research Center for Eye Diseases, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Junwei Fang
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, National Clinical Research Center for Eye Diseases, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Xiaoling Wan
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, National Clinical Research Center for Eye Diseases, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Shenping Li
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, National Clinical Research Center for Eye Diseases, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Shuchang Zhang
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, National Clinical Research Center for Eye Diseases, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Qing Gu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, National Clinical Research Center for Eye Diseases, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Qing Shao
- Department of Ophthalmology, Shanghai Aier Eye Hospital, Xuhui District, Shanghai Aier Eye Institute, Shanghai, China
| | - Jun Dong
- Department of Ophthalmology, Shanghai Aier Eye Hospital, Xuhui District, Shanghai Aier Eye Institute, Shanghai, China
| | - Xun Xu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, National Clinical Research Center for Eye Diseases, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Fang Wei
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, National Clinical Research Center for Eye Diseases, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Qiao Sun
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, National Clinical Research Center for Eye Diseases, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
- Department of Ophthalmology, Shanghai Aier Eye Hospital, Xuhui District, Shanghai Aier Eye Institute, Shanghai, China
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Fieß A, Wacker A, Gißler S, Fauer A, Mildenberger E, Urschitz MS, Elflein H, Stoffelns B, Pfeiffer N, Schuster AK. [Ophthalmic care of adults born preterm and full-term-results from the Gutenberg Prematurity Eye Study (GPES) : Premature birth and ophthalmological care]. DIE OPHTHALMOLOGIE 2023; 120:608-619. [PMID: 36416921 DOI: 10.1007/s00347-022-01746-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 09/28/2022] [Accepted: 10/04/2022] [Indexed: 06/13/2023]
Abstract
BACKGROUND Prematurity and the presence of retinopathy of prematurity (ROP) increase the risk for the occurrence of amblyogenic risk factors in childhood and adolescence. AIM The aim of the present study was to evaluate ocular morbidities and the ophthalmological care of former preterm and full-term persons in adulthood. MATERIAL AND METHODS The Gutenberg prematurity eye study (GPES) is a retrospective cohort study with a prospective ophthalmological examination of individuals formerly born preterm and full term between 1969 and 2002 (now aged 18-52 years). All participants underwent a detailed ophthalmological examination and were asked about the frequency of ophthalmological care. Participants were grouped into those with normal gestational age (GA) ≥ 37 weeks (control group), preterm individuals without ROP and GA 33-36 weeks (group 2), GA 29-32 weeks (group 3), GA ≤ 28 weeks (group 4), and those with ROP without treatment (group 5) and with ROP with treatment (group 6). All participants were asked if they had an ophthalmological examination within the last 12 months. RESULTS In total, data from 140 term and 310 preterm adults were included in the present study. Strabismus was present in 2.1 % (3/140), 6.6 % (9/137), 17.4 % (16/92), 11.1 % (2/18), 27.1 % (13/48) and 60 % (9/15) in groups 1-6, respectively. The proportion of subjects with an ophthalmological examination within the last 12 months was highest in the groups of extremely preterm persons with and without ROP compared with the control group. Overall, 33.3 % (1/3) of the term and 57.1 % (28/49) of the preterm subjects with strabismus and 0 % (0/3) of the term and 46.9 % (15/32) of the preterm individuals with amblyopia had an ophthalmological examination within the past 12 months. DISCUSSION Extremely preterm adults with and without postnatal ROP showed the highest rate of eye diseases as well as the highest rate of ophthalmological check-ups within the last 12 months. This suggests that extremely preterm adults particularly with the occurrence of postnatal ROP perceive more frequent ophthalmological check-ups throughout their lives.
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Affiliation(s)
- Achim Fieß
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum der Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland.
| | - Annika Wacker
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum der Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - Sandra Gißler
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum der Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - Agnes Fauer
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum der Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - Eva Mildenberger
- Abteilung für Neonatologie, Klinik für Kinderheilkunde, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Deutschland
| | - Michael S Urschitz
- Abteilung für Pädiatrische Epidemiologie, Institut für Medizinische Biostatistik, Epidemiologie und Informatik, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Deutschland
| | - Heike Elflein
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum der Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - Bernhard Stoffelns
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum der Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - Norbert Pfeiffer
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum der Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - Alexander K Schuster
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum der Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
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Chou YB, Wang AG, Yang HY, Chen KJ, Yang CS. Refractive status, biometric components, and functional outcomes of patients with threshold retinopathy of prematurity: systemic review and a 17-year longitudinal study. Graefes Arch Clin Exp Ophthalmol 2022; 260:3809-3816. [PMID: 35729410 DOI: 10.1007/s00417-022-05730-6] [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: 02/04/2022] [Revised: 05/01/2022] [Accepted: 06/07/2022] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE To assess the long-term refractive status, visual outcome, astigmatism, and the change in biometric optic components in older adolescents up to age 17 years with threshold retinopathy of prematurity (ROP) treated with diode laser. METHODS A retrospective, longitudinal study in which cycloplegic refraction, keratometry, and the biometric measurement of optic components were performed on 28 consecutive preterm eyes with laser-treated threshold ROP at age 17 years. The study results were statistically analysed and compared with age-matched full-term control. RESULTS All patients with ROP had myopia (average spherical equivalent of - 6.35 D, ranges from - 1.25 to - 12.38 D), and 12 eyes (43%) were highly myopic (spherical equivalent < - 6.0 D). Threshold ROP eyes exhibited a significantly poorer visual acuity (P < 0.001), greater cylinder refractive error (P < 0.001), higher corneal astigmatism (P < 0.001), and flatter horizontal corneal curvature (P = 0.01) compared with age-matched controls. Biometric optic components analysis revealed a significant shallower anterior chamber depth (P < 0.001), thicker lens (P < 0.001), and shorter axial length (P = 0.021) in laser-treated ROP eyes compared with age-matched controls. CONCLUSIONS In this 17-year longitudinal study, a higher prevalence of myopia and astigmatism was observed in laser-treated threshold ROP eyes compared with age-matched control eyes. Myopia and astigmatism in laser-treated ROP eyes typically progress through adolescence after school age. Therefore, we recommend that preterm patients with laser-treated threshold ROP should attend regular follow-up not only for refractive status but also for structural change of anterior segment until their adolescence.
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Affiliation(s)
- Yu-Bai Chou
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - An-Guor Wang
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Hsin-Yu Yang
- Department of Ophthalmology, Taipei Veterans General Hospital Yuanshan and Suao Branch, Yilan, Taiwan
| | - Kuan-Jung Chen
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chang-Sue Yang
- Department of Ophthalmology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
- Department of Ophthalmology, School of Medicine, Taipei Medical University, Taipei, Taiwan.
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8
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Dammann O, Hartnett ME, Stahl A. Retinopathy of prematurity. Dev Med Child Neurol 2022; 65:625-631. [PMID: 36408783 DOI: 10.1111/dmcn.15468] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 10/12/2022] [Accepted: 10/17/2022] [Indexed: 11/22/2022]
Abstract
Retinopathy of prematurity (ROP) is a devastating neurovascular disease of the retina in newborn infants that can lead to vision deficits or even blindness. In this concise review we discuss our current knowledge about diagnosis, etiology, pathogenesis, intervention, and outcomes of the disease. Major advancements have been made both in categorizing the disease in the new International Classification of Retinopathy of Prematurity, Third Edition classification and in treating severe ROP with anti-vascular endothelial growth factor (VEGF) agents. New development always creates new questions and opens up new areas of research. We will discuss in this review both the benefits and downsides of the new anti-VEGF treatment approaches in ROP, especially in light of our improved understanding of the underlying ROP pathophysiology. We also offer pointers to areas where more research is needed.
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Affiliation(s)
- Olaf Dammann
- Tufts University School of Medicine, Department of Public Health & Community Medicine, MA, Boston, USA.,Department of Obstetrics & Gynecology, Hannover Medical School, Hannover, Germany.,Department of Neuromedicine and Movement Science, Norwegian University of Science & Technology, Trondheim, Norway
| | - M Elizabeth Hartnett
- John A Moran Eye Center, Department of Ophthalmology and Visual Sciences, University of Utah Health, UT, Salt Lake City, USA
| | - Andreas Stahl
- Department of Ophthalmology Greifswald, University Medicine Greifswald, Mecklenburg-Vorpommern, Germany
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9
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Visual acuity, amblyopia, and vision-related quality of life in preterm adults with and without ROP: results from the Gutenberg prematurity eye study. Eye (Lond) 2022:10.1038/s41433-022-02207-y. [DOI: 10.1038/s41433-022-02207-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 06/30/2022] [Accepted: 08/10/2022] [Indexed: 11/08/2022] Open
Abstract
Abstract
Objectives
This study investigated the effects of prematurity and ROP on visual acuity and VRQoL in adults (18–52 years).
Methods
The Gutenberg Prematurity Eye Study is a retrospective cohort study with a prospective ophthalmologic examination. Preterm and full-term participants at an age from 18 to 52 years were included. Distant corrected visual acuity (DCVA) and VRQoL were assessed in participants (892 eyes of 450 individuals aged 28.6 ± 8.6 years, 251 females) grouped into full-term controls (gestational age [GA] at birth ≥37 weeks), preterm participants without ROP and GA 33–36 weeks (group 2), GA 29–32 weeks (group 3), GA ≤ 28 weeks (group 4), non-treated ROP (group 5) and treated ROP (group 6). Main outcome measures were distant corrected visual acuity (DCVA), VRQoL and prevalence of amblyopia.
Results
The DCVA of the better eye correlated (p < 0.001) with GA, birth weight, ROP, ROP treatment, and perinatal adverse events and was poorer in both ROP groups. Visual acuity of <20/200 in the better eye was observed in two participants (4.2%) in the ROP group and one person (6.7%) in the treated ROP group. The prevalence of amblyopia increased in the ROP groups. Compared to full-term controls, visual functioning VRQoL scores were lower in preterm individuals independent of ROP while socioemotional VRQoL scores were only lower in the treated ROP group.
Conclusion
Participants with postnatal ROP and its treatment showed decreased visual acuity and VRQol in adulthood, with amblyopia occurring more frequently in more preterm participants with ROP.
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10
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Zhou TE, Kassis PO, Qian C, Bérubé-Thevenet R, Chappaz A, Hamel P, Chemtob S, Nuyt AM, Luu TM. Reduced Contrast Sensitivity in Young Adults Who Had Retinopathy of Prematurity. Ophthalmol Retina 2022; 6:744-746. [PMID: 35430418 DOI: 10.1016/j.oret.2022.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 04/07/2022] [Accepted: 04/08/2022] [Indexed: 06/14/2023]
Affiliation(s)
- Tianwei Ellen Zhou
- Department of Ophthalmology & Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | | | - Cynthia Qian
- Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada; Department of Ophthalmology, CHU Sainte-Justine Hospital and Research Center, Montreal, Quebec, Canada
| | | | - Ariane Chappaz
- Department of Ophthalmology, CHU Sainte-Justine Hospital and Research Center, Montreal, Quebec, Canada
| | - Patrick Hamel
- Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada; Department of Ophthalmology, CHU Sainte-Justine Hospital and Research Center, Montreal, Quebec, Canada
| | - Sylvain Chemtob
- Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada; Department of Ophthalmology, CHU Sainte-Justine Hospital and Research Center, Montreal, Quebec, Canada; Department of Pediatrics, CHU Sainte-Justine Hospital and Research Center, Montreal, Quebec, Canada
| | - Anne-Monique Nuyt
- Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada; Department of Pediatrics, CHU Sainte-Justine Hospital and Research Center, Montreal, Quebec, Canada
| | - Thuy Mai Luu
- Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada; Department of Pediatrics, CHU Sainte-Justine Hospital and Research Center, Montreal, Quebec, Canada.
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11
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Lucchesi M, Marracci S, Amato R, Filippi L, Cammalleri M, Dal Monte M. Neurosensory Alterations in Retinopathy of Prematurity: A Window to Neurological Impairments Associated to Preterm Birth. Biomedicines 2022; 10:biomedicines10071603. [PMID: 35884908 PMCID: PMC9313429 DOI: 10.3390/biomedicines10071603] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/21/2022] [Accepted: 07/04/2022] [Indexed: 11/16/2022] Open
Abstract
Retinopathy of prematurity (ROP) is one of the main blinding diseases affecting preterm newborns and is classically considered a vascular disorder. The premature exposure to the extrauterine environment, which is hyperoxic in respect to the intrauterine environment, triggers a cascade of events leading to retinal ischemia which, in turn, makes the retina hypoxic thus setting off angiogenic processes. However, many children with a history of ROP show persistent vision impairment, and there is evidence of an association between ROP and neurosensory disabilities. This is not surprising given the strict relationship between neuronal function and an adequate blood supply. In the present work, we revised literature data evidencing to what extent ROP can be considered a neurodegenerative disease, also taking advantage from data obtained in preclinical models of ROP. The involvement of different retinal cell populations in triggering the neuronal damage in ROP was described along with the neurological outcomes associated to ROP. The situation of ROP in Italy was assessed as well.
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Affiliation(s)
- Martina Lucchesi
- Department of Biology, University of Pisa, 56127 Pisa, Italy; (M.L.); (S.M.); (R.A.); (M.C.)
| | - Silvia Marracci
- Department of Biology, University of Pisa, 56127 Pisa, Italy; (M.L.); (S.M.); (R.A.); (M.C.)
| | - Rosario Amato
- Department of Biology, University of Pisa, 56127 Pisa, Italy; (M.L.); (S.M.); (R.A.); (M.C.)
| | - Luca Filippi
- Department of Clinical and Experimental Medicine, Division of Neonatology and NICU, University of Pisa, 56126 Pisa, Italy;
| | - Maurizio Cammalleri
- Department of Biology, University of Pisa, 56127 Pisa, Italy; (M.L.); (S.M.); (R.A.); (M.C.)
| | - Massimo Dal Monte
- Department of Biology, University of Pisa, 56127 Pisa, Italy; (M.L.); (S.M.); (R.A.); (M.C.)
- Correspondence: ; Tel.: +39-050-2211426
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12
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Pétursdóttir D, Holmström G, Larsson E. Strabismus, stereoacuity, accommodation and convergence in young adults born premature and screened for retinopathy of prematurity. Acta Ophthalmol 2022; 100:e791-e797. [PMID: 34313013 DOI: 10.1111/aos.14987] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 05/14/2021] [Accepted: 07/09/2021] [Indexed: 01/01/2023]
Abstract
PURPOSE The aim of the study was to evaluate strabismus, stereoacuity, accommodation and convergence in prematurely born young adults; screened for retinopathy of prematurity in the neonatal period and compare with term-born individuals of the same age. MATERIALS AND METHODS The study participants included 59 prematurely born individuals with a birthweight of ≤1,500 grams and 44 term-born controls, all born during 1988-1990 in Stockholm County, Sweden. Ocular alignment was assessed with a cover test, stereoacuity with the TNO stereo test and the amplitude of accommodation and the near point of convergence with the Royal Air Force Rule. RESULTS Seven of 59 (12%) preterms had manifest strabismus, 4/59 (7%) had esotropia and 3/59 (5%) exotropia. One of 44 (2%) controls had esotropia; no other controls had manifest strabismus. Stereoacuity was within normal limits in 38/59 (64%) preterms and 43/44 (98%) controls, p < 0.01; the difference remained after excluding those with strabismus. A neurological complication at 2.5 years of age was the strongest risk factor for subnormal stereoacuity within the preterm group after excluding those with strabismus. The mean amplitude of accommodation was poorer in the preterms than the controls in better (p < 0.05) and worse eyes (p < 0.05). The preterms were more likely to have an amplitude of accommodation below the minimum, according to Hofstetter's equation. There were no differences between the groups regarding the near point of convergence. CONCLUSION Prematurely born young adults had a higher prevalence of strabismus, reduced stereoacuity and worse amplitude of accommodation than term-born controls.
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Affiliation(s)
| | - Gerd Holmström
- Department of Neuroscience/Ophthalmology Uppsala University Uppsala Sweden
| | - Eva Larsson
- Department of Neuroscience/Ophthalmology Uppsala University Uppsala Sweden
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13
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Fieß A, Fauer A, Mildenberger E, Urschitz MS, Elflein HM, Zepp F, Stoffelns B, Pfeiffer N, Schuster AK. Refractive error, accommodation and lens opacification in adults born preterm and full-term: Results from the Gutenberg Prematurity Eye Study (GPES). Acta Ophthalmol 2022; 100:e1439-e1450. [PMID: 35297183 DOI: 10.1111/aos.15116] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 02/14/2022] [Indexed: 02/01/2023]
Affiliation(s)
- Achim Fieß
- Department of Ophthalmology University Medical Center of the Johannes Gutenberg University Mainz Mainz Germany
| | - Agnes Fauer
- Department of Ophthalmology University Medical Center of the Johannes Gutenberg University Mainz Mainz Germany
| | - Eva Mildenberger
- Division of Neonatology, Department of Pediatrics University Medical Center of the Johannes Gutenberg‐University Mainz Mainz Germany
| | - Michael S. Urschitz
- Division of Pediatric Epidemiology, Institute for Medical Biostatistics, Epidemiology and Informatics University Medical Center of the Johannes Gutenberg University Mainz Mainz Germany
| | - Heike M. Elflein
- Department of Ophthalmology University Medical Center of the Johannes Gutenberg University Mainz Mainz Germany
| | - Fred Zepp
- Division of Neonatology, Department of Pediatrics University Medical Center of the Johannes Gutenberg‐University Mainz Mainz Germany
| | - Bernhard Stoffelns
- Department of Ophthalmology University Medical Center of the Johannes Gutenberg University Mainz Mainz Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology University Medical Center of the Johannes Gutenberg University Mainz Mainz Germany
| | - Alexander K. Schuster
- Department of Ophthalmology University Medical Center of the Johannes Gutenberg University Mainz Mainz Germany
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14
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Pétursdóttir D, Holmström G, Larsson E. Refraction and its development in young adults born prematurely and screened for retinopathy of prematurity. Acta Ophthalmol 2022; 100:189-195. [PMID: 33528099 DOI: 10.1111/aos.14766] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 12/07/2020] [Accepted: 12/29/2020] [Indexed: 01/10/2023]
Abstract
PURPOSE To evaluate refraction and its development in young adults born prematurely, screened for retinopathy of prematurity, and to compare with individuals of the same age born at term. MATERIALS AND METHODS The participants were 59 preterms, with a birthweight of ≤ 1500 g, and 43 term-born controls, all born during 1988-1990. The refraction was measured in cycloplegia, and the spherical equivalent (SE) was calculated. The axial length (AL), anterior chamber depth and corneal radius (CR) were measured, and the AL/CR ratio was calculated. RESULTS The mean SE was -0.5 dioptres (D) (SD 2.5) in right eyes (REs) and -0.4 D (SD 2.3) in left eyes (LEs) of preterms, and -0.2 D (SD 1.5) in REs and -0.2 D (SD 1.5) in LEs of controls. The distribution of refraction was wider in the preterm group compared to the control group. In the preterm group, 12% had a SE ≥ 1.5 D, but none of the controls. Ten preterms, but none of the controls, had anisometropia ≥ 1.0 D. The prevalence of astigmatism ≥ 1.0 D was higher in preterms than controls. The SE decreased around 1 D in both preterms and controls from 10 to 25 years of age. The AL and CR were shorter in the preterms; however, the AL/CR ratio was similar in both groups. Within the preterm group, cryotherapy was correlated with astigmatism, but not with SE and anisometropia at this age. CONCLUSION Prematurely born individuals had higher prevalence of refractive errors in young adulthood compared to term-born controls.
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Affiliation(s)
| | - Gerd Holmström
- Institution of Neuroscience/Ophthalmology Uppsala University Uppsala Sweden
| | - Eva Larsson
- Institution of Neuroscience/Ophthalmology Uppsala University Uppsala Sweden
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15
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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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16
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Pétursdóttir D, Holmström G, Larsson E, Böhm B. Visual-motor functions are affected in young adults who were born premature and screened for retinopathy of prematurity. Acta Paediatr 2021; 110:127-133. [PMID: 32473041 DOI: 10.1111/apa.15378] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 04/27/2020] [Accepted: 05/25/2020] [Indexed: 01/23/2023]
Abstract
AIM To assess visual-motor integration in young adults previously included in a prospective study on the incidence of retinopathy of prematurity (ROP). METHODS The study encompassed 59 preterm individuals, born 1988-1990, with a birth weight ≤1500 g, and 44 full-term controls, aged 25-29 years. Ophthalmological examination, including visual acuity and contrast sensitivity, and the Beery Visual-Motor Integration (VMI) with supplemental tests of visual perception and motor coordination, were performed. A short questionnaire was filled in. RESULTS The preterm individuals had significantly lower scores than the controls in all VMI tests, median values and interquartile ranges: Beery VMI 87 (21) vs 103 (11), visual perception 97 (15) vs 101 (8) and motor coordination 97 (21) vs 102 (15), respectively. Within the preterm group, no correlations were found between the VMI tests and ROP, gestational age, birth weight or visual acuity. Contrast sensitivity was correlated to visual perception. Neurological complication at 2.5 years was a risk factor for lower scores on Beery VMI. The preterm subjects reported six times as many health problems as compared to the controls. CONCLUSION Being born preterm seemed to have life-long effects. This study shows that visual-motor integration was affected in young adults born preterm.
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Affiliation(s)
| | - Gerd Holmström
- Institution of Neuroscience/Ophthalmology Uppsala University Uppsala Sweden
| | - Eva Larsson
- Institution of Neuroscience/Ophthalmology Uppsala University Uppsala Sweden
| | - Birgitta Böhm
- Department of Women’s and Children’s Health Karolinska Institute Stockholm Sweden
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17
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Leung M, Black J, Bloomfield FH, Gamble GD, Harding JE, Jiang Y, Poppe T, Thompson B, Tottman AC, Wouldes TA, Alsweiler JM. Effects of Neonatal Hyperglycemia on Retinopathy of Prematurity and Visual Outcomes at 7 Years of Age: A Matched Cohort Study. J Pediatr 2020; 223:42-50.e2. [PMID: 32711750 DOI: 10.1016/j.jpeds.2020.04.059] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 03/06/2020] [Accepted: 04/23/2020] [Indexed: 01/31/2023]
Abstract
OBJECTIVE To determine whether neonatal hyperglycemia is associated with retinopathy of prematurity (ROP), visual outcomes, and ocular growth at 7 years of age. STUDY DESIGN Children born preterm (<30 weeks of gestational age) at a tertiary hospital in Auckland, New Zealand, who developed neonatal hyperglycemia (2 blood glucose concentrations ≥153 mg/dL [8.5 mmol/L] 4 hours apart) were matched with children who were not hyperglycemic (matching criteria: sex, gestational age, birth weight, age, socioeconomic status, and multiple birth) and assessed at 7 years of corrected age. The primary outcome, favorable overall visual outcome (visual acuity ≤0.3 logarithm of the minimum angle of resolution, no strabismus, stereoacuity ≤240 arcsec, not requiring spectacles) was compared between groups using generalized matching criteria-adjusted linear regression models. RESULTS Assessments were performed on 57 children with neonatal hyperglycemia (hyperglycemia group) and 54 matched children without hyperglycemia (control group). There were no differences in overall favorable visual outcome (OR 0.95, 95% CI 0.42-2.13, P = .90) or severe ROP incidence (OR 2.20, 95% CI 0.63-7.63, P = .21) between groups. Children with hyperglycemia had poorer binocular distance visual acuity (mean difference 0.08, 95% CI 0.03-0.14 logarithm of the minimum angle of resolution, P < .01), more strabismus (OR 6.22, 95% CI 1.31-29.45, P = .02), and thicker crystalline lens (mean difference 0.14, 95% CI 0.04-0.24 mm, P < .01). Maximum blood glucose concentration was greater in the ROP-treated group compared with the ROP-not treated and no ROP groups after adjusting for sex, gestational age, and birth weight z score (P = .02). CONCLUSIONS Neonatal hyperglycemia was not associated with overall visual outcomes at 7 years of age. However, there were between-group differences for specific outcome measures relating to interocular lens growth and binocular vision. Further follow-up is required to determine implications on long-term visual outcome.
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Affiliation(s)
- Myra Leung
- School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand; Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand; Department of Optometry and Vision Science, University of Canberra, Canberra, Australia
| | - Joanna Black
- School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
| | | | - Greg D Gamble
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Jane E Harding
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Yannan Jiang
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Tanya Poppe
- School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
| | - Benjamin Thompson
- School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand; School of Optometry and Vision Science, University of Waterloo, Ontario, Canada
| | - Anna C Tottman
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Trecia A Wouldes
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Jane M Alsweiler
- Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand; Newborn Services, National Women's Health, Auckland City Hospital, Auckland, New Zealand
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18
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Jung E, Romero R, Yeo L, Diaz-Primera R, Marin-Concha J, Para R, Lopez AM, Pacora P, Gomez-Lopez N, Yoon BH, Kim CJ, Berry SM, Hsu CD. The fetal inflammatory response syndrome: the origins of a concept, pathophysiology, diagnosis, and obstetrical implications. Semin Fetal Neonatal Med 2020; 25:101146. [PMID: 33164775 PMCID: PMC10580248 DOI: 10.1016/j.siny.2020.101146] [Citation(s) in RCA: 104] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The fetus can deploy a local or systemic inflammatory response when exposed to microorganisms or, alternatively, to non-infection-related stimuli (e.g., danger signals or alarmins). The term "Fetal Inflammatory Response Syndrome" (FIRS) was coined to describe a condition characterized by evidence of a systemic inflammatory response, frequently a result of the activation of the innate limb of the immune response. FIRS can be diagnosed by an increased concentration of umbilical cord plasma or serum acute phase reactants such as C-reactive protein or cytokines (e.g., interleukin-6). Pathologic evidence of a systemic fetal inflammatory response indicates the presence of funisitis or chorionic vasculitis. FIRS was first described in patients at risk for intraamniotic infection who presented preterm labor with intact membranes or preterm prelabor rupture of the membranes. However, FIRS can also be observed in patients with sterile intra-amniotic inflammation, alloimmunization (e.g., Rh disease), and active autoimmune disorders. Neonates born with FIRS have a higher rate of complications, such as early-onset neonatal sepsis, intraventricular hemorrhage, periventricular leukomalacia, and death, than those born without FIRS. Survivors are at risk for long-term sequelae that may include bronchopulmonary dysplasia, neurodevelopmental disorders, such as cerebral palsy, retinopathy of prematurity, and sensorineuronal hearing loss. Experimental FIRS can be induced by intra-amniotic administration of bacteria, microbial products (such as endotoxin), or inflammatory cytokines (such as interleukin-1), and animal models have provided important insights about the mechanisms responsible for multiple organ involvement and dysfunction. A systemic fetal inflammatory response is thought to be adaptive, but, on occasion, may become dysregulated whereby a fetal cytokine storm ensues and can lead to multiple organ dysfunction and even fetal death if delivery does not occur ("rescued by birth"). Thus, the onset of preterm labor in this context can be considered to have survival value. The evidence so far suggests that FIRS may compound the effects of immaturity and neonatal inflammation, thus increasing the risk of neonatal complications and long-term morbidity. Modulation of a dysregulated fetal inflammatory response by the administration of antimicrobial agents, anti-inflammatory agents, or cell-based therapy holds promise to reduce infant morbidity and mortality.
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Affiliation(s)
- Eunjung Jung
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD, and Detroit, MI, USA; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Roberto Romero
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD, and Detroit, MI, USA; Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA; Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA; Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI, USA; Detroit Medical Center, Detroit, MI, USA; Department of Obstetrics and Gynecology, Florida International University, Miami, FL, USA.
| | - Lami Yeo
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD, and Detroit, MI, USA; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Ramiro Diaz-Primera
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD, and Detroit, MI, USA; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Julio Marin-Concha
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD, and Detroit, MI, USA; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Robert Para
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD, and Detroit, MI, USA; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Ashley M Lopez
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD, and Detroit, MI, USA; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Percy Pacora
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD, and Detroit, MI, USA; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Nardhy Gomez-Lopez
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD, and Detroit, MI, USA; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA; Department of Biochemistry, Microbiology and Immunology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Bo Hyun Yoon
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD, and Detroit, MI, USA; Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Chong Jai Kim
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD, and Detroit, MI, USA; Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Stanley M Berry
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD, and Detroit, MI, USA; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Chaur-Dong Hsu
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD, and Detroit, MI, USA; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA; Department of Physiology, Wayne State University School of Medicine, Detroit, MI, USA
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Morken TS, Dammann O, Skranes J, Austeng D. Retinopathy of prematurity, visual and neurodevelopmental outcome, and imaging of the central nervous system. Semin Perinatol 2019; 43:381-389. [PMID: 31174874 DOI: 10.1053/j.semperi.2019.05.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Recent findings indicate that retinopathy of prematurity (ROP), presently classified by clinical examinations of retinal vascular tissue, is associated with structural alterations of the central nervous system. Such alterations may be the correlate of the association between ROP and impaired long-term neurocognitive and visual development. The advent of imaging techniques such as structural and diffusion tensor magnetic resonance imaging of the brain, and optical coherence tomography of the retina, will allow the complete visual system to be characterized in greater detail. It has been suggested that ROP may be not only a vascular, but a neurovascular disease, being part of a spectrum that includes pathological development in both the retinal and cerebral neurovascular interphase. We review the present knowledge in the field and point to future directions for research to tackle these questions.
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Affiliation(s)
- Tora Sund Morken
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Norway and Department of Ophthalmology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
| | - Olaf Dammann
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA; Department of Gynecology and Obstetrics, Hannover Medical School, Hannover, Germany
| | - Jon Skranes
- Department of Clinical and Molecular Medicine, NTNU, Trondheim, Norway; Department of Child Neurology and Rehabilitation and Regional Competence Center for children with prenatal alcohol/drug exposure, Sørlandet Hospital, Arendal, Norway
| | - Dordi Austeng
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Norway and Department of Ophthalmology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
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20
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Pétursdóttir D, Holmström G, Larsson E. Visual function is reduced in young adults formerly born prematurely: a population-based study. Br J Ophthalmol 2019; 104:541-546. [PMID: 31302630 PMCID: PMC7147170 DOI: 10.1136/bjophthalmol-2019-314429] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 05/27/2019] [Accepted: 06/17/2019] [Indexed: 12/28/2022]
Abstract
Aims To assess visual function in young adults born preterm and compare with full-term individuals of the same age. Methods Young adults, born preterm (birth weight ≤1500 g) in 1988–1990, previously included in a population-based study on the incidence of retinopathy of prematurity (ROP) in Stockholm County, Sweden were included. A control group of participants born at term, in the same area during the same time period, was used for comparison. Best-corrected visual acuities were assessed at distance and near with logMAR charts. Distance visual acuity was also measured with single symbols to calculate crowding. Visual fields were measured with Humphrey 24-2 and the mean deviation was noted. Contrast sensitivity was assessed with Vistech contrast sensitivity test and the area under the curve was calculated. Results Fifty-nine preterm (females 37) and 44 full-term (females 18) individuals were included. All individuals were between 25 and 29 years of age. Preterm individuals had significantly lower distance visual acuity (mean −0.08 (SD 0.11) vs −0.14 (SD 0.07) logMAR, p=0.009), near visual acuity (mean −0.08 (SD 0.11) vs −0.13 (SD 0.06) logMAR, p=0.049), mean deviation (mean −1.09 (SD 1.13) vs −0.80 (SD 1.03) dB, p=0.05) and contrast sensitivity (mean 2.02 (SD 0.19) vs 2.16 (SD 0.14), p<0.001) in the better eye compared with full-term individuals. The differences in distance visual acuity and contrast sensitivity were also evident after excluding persons with previous ROP and neurological complications. In multivariable analyses, treated ROP was a risk factor for reduced near visual acuity and visual fields. Conclusion Visual function seems to be reduced in prematurely born individuals even in adulthood. The reason may be prematurity per se since individuals without previous ROP or neurological complications are also affected. Synopsis Visual function, assessed as visual acuity, visual fields and contrast sensitivity, was reduced in young adults born preterm and previously included in a population-based study on the incidence of retinopathy of prematurity, as compared with controls.
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Affiliation(s)
| | - Gerd Holmström
- Institution of Neuroscience/Ophthalmology, Uppsala University, Uppsala, Sweden
| | - Eva Larsson
- Institution of Neuroscience/Ophthalmology, Uppsala University, Uppsala, Sweden
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Abstract
Introduction Retinopathy of prematurity (ROP) is a leading cause of childhood blindness worldwide. Areas covered Recent methods to identify and manage treatment-warranted vascularly active ROP are recognized and being compared to standard care by laser treatment in prospective large-scale clinical studies. Pharmacologic anti-angiogenic (anti-VEGF) treatment has changed the natural history of vascularly active ROP by reducing stage 3 intravitreal neovascularization and extending physiologic retinal vascularization in many infants. Tractional retinal detachments in stage 4 ROP after treatment with anti-VEGF agents show additional fibrovascular complexity compared to eyes treated with laser only. We review current management and outcomes for vascularly active and fibrovascular retinal detachment in ROP (stages 3, 4, 5 ROP), highlighting the evidence from recent clinical studies. Included are technical details important in surgery for retinal detachment in ROP. Literature searches were employed through PubMed. Expert opinion Methods in pediatric imaging, safer pharmacologic treatments, and surgical techniques continue to advance to improve future ROP outcomes.
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Affiliation(s)
- Eric D Hansen
- John A. Moran Eye Center, University of Utah, Salt Lake City, USA
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