Retinopathy of prematurity-current diagnosis and management

Göbel, Werner; Richard, Gisbert

doi:10.1007/bf01956734

Cited by 12 publications

(3 citation statements)

References 40 publications

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“…Infants were screened for retinopathy of prematurity (ROP) at 4 weeks of age and thereafter once weekly as needed until vascularization was complete. 19 ROP requiring treatment with laser or cryotherapy (stage III or more) was reported. Mortality was defined as death before discharge.…”

Section: Study Populationsmentioning

confidence: 99%

Implementation of surfactant treatment during continuous positive airway pressure

et al. 2007

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Objective: To study the effects of implementing a method for surfactant administration by transient intubation, INSURE (i.e. INtubation SURfactant Extubation) during nasal continuous positive airway pressure (nCPAP) for moderately preterm infants with respiratory distress syndrome (RDS).Study design: A descriptive, retrospective, bi-center study in Stockholm, Sweden, comparing mechanical ventilation (MV) rates, surfactant use, treatment response and outcome of all inborn infants with gestational age 27 to 34 weeks and RDS, (n ¼ 420), during the 5-year periods before and after the introduction of the INSURE-strategy at one of the centers (Karolinska Huddinge) in 1998. The other center (Karolinska Solna) continued conventional surfactant therapy in conjunction with MV throughout the study.Results: Implementation of INSURE at Karolinska Huddinge reduced the number of infants requiring MV by 50% (P<0.01), resulted in earlier surfactant administration and increased overall surfactant use. INSURE-treatment improved oxygenation and the treatment response was sustained over time with only 17% of the infants requiring >1 dose of surfactant. At Karolinska Solna, the MV rates were unaltered between the first and second 5-year period.Conclusion: Implementing a strategy of surfactant administration by transient intubation during nCPAP reduces the need for MV without adverse effects on outcome and may be an option to more effectively treat RDS, particularly in a care setting where transfer is necessary to provide MV.

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Section: Study Populationsmentioning

confidence: 99%

Implementation of surfactant treatment during continuous positive airway pressure

et al. 2007

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“…The cytoplasm of RPE cells also contains high levels of vitamin E (Stephens et al, 1988) which protect the cells from oxidative reactions that involve free radicals and polyunsaturated fatty acids. Moreover, exogenous antioxidants have been suggested to protect the retina from oxidative damage (Gobel and Richard, 1993;Muller, 1992).…”

Section: Discussionmentioning

confidence: 99%

Heme-mediated reactive oxygen species toxicity to retinal pigment epithelial cells is reduced by hemopexin

1996

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Catalysis of the formation of reactive oxygen species (RO2S) by low molecular weight complexes of iron has been implicated in several pathological conditions in the retina since photoreceptors and retinal pigment epithelial cells are likely to be especially sensitive to RO2S. Since protective proteins cannot cross the blood-retinal barrier, it is likely that the retina performs its own protective functions by synthesizing proteins that bind iron and nonprotein iron complexes, the major catalysts of RO2S generation. Investigations were carried out to determine whether pigment epithelial cells are themselves sensitive to iron-generated RO2S and whether apo-transferrin and apo-hemopexin, known to be made locally in the retina, can perform a protective function. In 51Cr release assays, the toxicity of exogenous RO2S including hydrogen peroxide or superoxide (generated by xanthine oxidase/hypoxanthine) to human retinal pigment epithelial cells was inhibited by the iron chelators, desferrioxamine and apo-transferrin. Free but not protein-bound ferric iron and heme exacerbated the toxic effect. The toxic effect of heme was abolished by the heme-scavenging, extracellular antioxidant, apo-hemopexin, and also by exogenous bovine serum albumin. In addition, heme toxicity was inhibited by a 3 h preincubation of cells with either heme, apo-hemopexin, or heme-hemopexin 24 h prior to the toxicity assay. It is concluded, first, that toxic effects of iron and heme can be prevented by apo-transferrin or apo-hemopexin and, second, that exposure of RPE cells to free heme or hemopexin sets in motion a series of biochemical events resulting in protection against oxidative stress. It is probable that these include heme oxygenase induction.

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“…The initial fundus examination was performed 4 weeks postnatally, with further follow-up every 7-10 days until full vascularization of the retina, stabilization of the changes or the necessity for treatment. Findings were classified according to the Revisited International Classification of Retinopathy of Prematurity (ICROP) 27,28 .…”

Section: Ropmentioning

confidence: 99%

Single nucleotide vitamin D receptor polymorphisms (FokI, BsmI, ApaI, and TaqI) in the pathogenesis of prematurity complications

Kosik

Szpecht

Al-Saad

et al. 2020

Sci Rep

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The vitamin D receptor (VDR), coded by the VDR gene, plays a pivotal role in executing cellular functions when bound by the active form of vitamin D. Gene polymorphisms in this receptor have been increasingly associated with a heightened state of vulnerability to certain diseases. However, limited data is available concerning the role of VDR gene polymorphisms in preterm infant complications. In 114 premature infants (< 32 weeks gestation) we analyze four single nucleotide VDR polymorphisms (rs2228570 (FokI), rs1544410 (BsmI), rs797532 (ApaI), rs731236 (TaqI)) for their association with respiratory distress syndrome (RDS), intraventricular hemorrhage (IVH), bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC) and retinopathy of prematurity (ROP). The results show that BPD was almost four times more likely in infants with the genotype CC of ApaI (rs7975232) (OR 3.845; p = 0.038). While both BPD and NEC were 2.1 times more likely to occur in preterm infants with the allele C of ApaI (rs7975232) (respectively: OR 2.111 and OR 2.129, p < 0.05). The ApaI VDR polymorphism appears to influence incidence of BPD and NEC in preterm infants. Considering VDR polymorphisms in future genetic investigations, in preterm complications, may prove clinically relevant.

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Retinopathy of prematurity-current diagnosis and management

Cited by 12 publications

References 40 publications

Implementation of surfactant treatment during continuous positive airway pressure

Implementation of surfactant treatment during continuous positive airway pressure

Heme-mediated reactive oxygen species toxicity to retinal pigment epithelial cells is reduced by hemopexin

Single nucleotide vitamin D receptor polymorphisms (FokI, BsmI, ApaI, and TaqI) in the pathogenesis of prematurity complications

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