Early light reduction for preventing retinopathy of prematurity in very low birth weight infants

Jorge, Eliane Chaves; Jorge, Edson Nacib; Dib, Regina El

doi:10.1002/14651858.cd000122.pub2

Cited by 17 publications

(12 citation statements)

References 29 publications

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“…The previous LIGHT-ROP trial (Reynolds et al, 2002; Reynolds et al, 1998), conceived and run in the era when photic injury to the retina by military and medical equipment exposures was of great concern, was based on the premise that light was injurious to the retina. Limiting light exposure to the eyes of premature infants had no effect on the incidence and severity of ROP (Jorge et al, 2013; Phelps and Watts, 2000, 2001). However, a low, non-injurious level of light, rather than dark, is known to decrease the circulating current.…”

Section: Summary and Future Directionsmentioning

confidence: 92%

The neural retina in retinopathy of prematurity

Hansen

Moskowitz

Akula

et al. 2017

Progress in Retinal and Eye Research

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Retinopathy of prematurity (ROP) is a neurovascular disease that affects prematurely born infants and is known to have significant long term effects on vision. We conducted the studies described herein not only to learn more about vision but also about the pathogenesis of ROP. The coincidence of ROP onset and rapid developmental elongation of the rod photoreceptor outer segments motivated us to consider the role of the rods in this disease. We used noninvasive electroretinographic (ERG), psychophysical, and retinal imaging procedures to study the function and structure of the neurosensory retina. Rod photoreceptor and post-receptor responses are significantly altered years after the preterm days during which ROP is an active disease. The alterations include persistent rod dysfunction, and evidence of compensatory remodeling of the post-receptor retina is found in ERG responses to full-field stimuli and in psychophysical thresholds that probe small retinal regions. In the central retina, both Mild and Severe ROP delay maturation of parafoveal scotopic thresholds and are associated with attenuation of cone mediated multifocal ERG responses, significant thickening of post-receptor retinal laminae, and dysmorphic cone photoreceptors. These results have implications for vision and control of eye growth and refractive development and suggest future research directions. These results also lead to a proposal for noninvasive management using light that may add to the currently invasive therapeutic armamentarium against ROP.

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Section: Summary and Future Directionsmentioning

confidence: 92%

The neural retina in retinopathy of prematurity

Hansen

Moskowitz

Akula

et al. 2017

Progress in Retinal and Eye Research

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“…We hypothesized that when compared to infants receiving LCL, infants receiving ECL would gain weight faster, be discharged from the hospital earlier with lower costs, and have better sleep and neurodevelopmental (mental, motor, visual acuity) outcomes. Retinopathy of prematurity (ROP) and hearing outcomes were measured to insure safety; we hypothesized there would be no differences between the ECL and LCL interventions, based on previous evidence that reduced light exposure has no effect on ROP severity (Jorge, Jorge, & El Dib, ) or sensory development (Brandon et al, ).…”

mentioning

confidence: 99%

Timing for the Introduction of Cycled Light for Extremely Preterm Infants: A Randomized Controlled Trial

Brandon

Silva

Park

et al. 2017

Research in Nursing & Health

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Day-night cycled light improves health outcomes in preterm infants, yet the best time to institute cycled light is unclear. The hypothesis of this study was that extremely preterm infants receiving early cycled light would have better health and developmental outcomes than infants receiving late cycled light. Infants born at ≤28 weeks gestation were randomly assigned to early cycled light (ECL) starting at 28 weeks postmenstrual age [PMA]) or late cycled light (LCL), starting at 36 weeks PMA. Daylight was 200–600 lux and night was 5–30 lux. Primary outcomes were weight over time and length of hospitalization. Secondary outcomes were hospital costs, sleep development, and neurodevelopment at 9, 18 and 24 months corrected age. Of 121 infants randomized, 118 were included in analysis. Weight gain in the two groups did not differ significantly but increased across time in both groups. In PMA weeks 36 to 44, the mean weight gain was 193.8 grams in the ECL group compared to 176.3 grams in the LCL group. Effect sizes for weight were Cohen d=0.26 and 0.36 for 36 and 44 weeks PMA. Infants in the ECL group went home an average of 5.5 days earlier than the LCL group, but this difference was not statistically significant. There were no group differences on neurodevelopmental outcomes. Although statistically non-significant, clinically important differences of improved weight gain and decreased hospital stay were observed with ECL. The small observed effect sizes on weight during hospitalization should be considered in future cycled light research with extremely preterm infants.

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“…(140) There was no effect on ROP severity by reducing light. A subsequent Cochrane review also showed no effect on ROP from light exposure during the first 7 postnatal days (90). …”

Section: Current Clinical Trialsmentioning

confidence: 99%

Advances in understanding and management of retinopathy of prematurity

Hartnett

2017

Survey of Ophthalmology

117

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The understanding, diagnosis and treatment of retinopathy of prematurity (ROP) have changed in the last seventy years since the original description of retrolental fibroplasia associated with high oxygenation. It is now recognized that ROP differs in appearance world-wide and as ever smaller and younger premature infants survive. New methods are being evaluated to image the retina, diagnose severe ROP, and determine windows of time for treatment to save eyes and improve visual and neural outcomes. New treatments to promote physiologic retinal vascular development, vascular repair, and inhibit vasoproliferation by regulating proteins involved in vascular endothelial growth factor, insulin-like growth factor, or erythropoietin signaling. Reducing excessive oxidative/nitrosative stress and understanding progenitor cells and neurovascular and glial vascular interactions are being studied.

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Early light reduction for preventing retinopathy of prematurity in very low birth weight infants

Abstract: Early light reduction for preventing retinopathy of prematurity in very low birth weight infants (Review)

Cited by 17 publications

References 29 publications

The neural retina in retinopathy of prematurity

The neural retina in retinopathy of prematurity

Timing for the Introduction of Cycled Light for Extremely Preterm Infants: A Randomized Controlled Trial

Advances in understanding and management of retinopathy of prematurity

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