Role of cytokines and treatment algorithms in retinopathy of prematurity

Hartnett, M. Elizabeth

doi:10.1097/icu.0000000000000360

Cited by 14 publications

(6 citation statements)

References 47 publications

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“…Although prematurity and oxygen exposure are central in the etiology of ROP, neonatal inflammation and infection may have a deleterious impact on retinal angiogenesis, aggravating the risk of ROP [ 114 , 115 ]. Pro-inflammatory cytokines, such as TNF-α and IL-6, as well as vascular endothelial growth factor (VEGF) and insulin-like growth factor 1 (IGF-1) are associated with dysregulated vascularization [ 20 , 114 ]. S. epidermidis is one of the prevalent pathogens of endophthalmitis in adults, indicating its potential to cause ocular inflammatory injury [ 116 ].…”

Section: Retinopathy Of Prematuritymentioning

confidence: 99%

Beyond sepsis: Staphylococcus epidermidis is an underestimated but significant contributor to neonatal morbidity

Dong

Speer²,

Glaser³

2018

Virulence

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Staphylococcus epidermidis accounts for the majority of cases of neonatal sepsis. Moreover, it has been demonstrated to be associated with neonatal morbidities, such as bronchopulmonary dysplasia (BPD), white matter injury (WMI), necrotizing enterocolitis (NEC) and retinopathy of prematurity (ROP), which affect short-term and long-term neonatal outcome. Imbalanced inflammation has been considered to be a major underlying mechanism of each entity. Conventionally regarded as a harmless commensal on human skin, S. epidermidis has received less attention than its more virulent relative Staphylococcus aureus. Particularities of neonatal innate immunity and nosocomial environmental factors, however, may contribute to the emergence of S. epidermidis as a significant nosocomial pathogen. Neonatal host response to S. epidermidis sepsis has not been fully elucidated. Evidence is emerging regarding the implication of S. epidermidis sepsis in the pathogenesis of neonatal inflammatory diseases. This review focuses on the interplay among S. epidermidis, neonatal innate immunity and inflammation-driven organ injury.

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Section: Retinopathy Of Prematuritymentioning

confidence: 99%

Beyond sepsis: Staphylococcus epidermidis is an underestimated but significant contributor to neonatal morbidity

Dong

Speer²,

Glaser³

2018

Virulence

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“…The use of anti-VEGF agents in the management of ROP is becoming increasingly popular globally, [33][34][35] including in this study where, in the absence of lasers, it was the primary treatment in most infants (92.3%). Advantages of anti-VEGF treatment over laser include that it is quicker to administer, can give early resolution of active disease, and may be associated with fewer cases of early-onset high myopia.…”

Section: Discussionmentioning

confidence: 84%

Strengthening retinopathy of prematurity screening and treatment services in Nigeria: a case study of activities, challenges and outcomes 2017-2020

et al. 2021

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ObjectivesRetinopathy of prematurity (ROP) will become a major cause of blindness in Nigerian children unless screening and treatment services expand. This article aims to describe the collaborative activities undertaken to improve services for ROP between 2017 and 2020 as well as the outcome of these activities in Nigeria.DesignDescriptive case study.SettingNeonatal intensive care units in Nigeria.ParticipantsStaff providing services for ROP, and 723 preterm infants screened for ROP who fulfilled screening criteria (gestational age <34 weeks or birth weight ≤2000 g, or sickness criteria).Methods and analysisA WhatsApp group was initiated for Nigerian ophthalmologists and neonatologists in 2018. Members participated in a range of capacity-building, national and international collaborative activities between 2017 and 2018. A national protocol for ROP was developed for Nigeria and adopted in 2018; 1 year screening outcome data were collected and analysed. In 2019, an esurvey was used to collect service data from WhatsApp group members for 2017–2018 and to assess challenges in service provision.ResultsIn 2017 only six of the 84 public neonatal units in Nigeria provided ROP services; this number had increased to 20 by 2018. Of the 723 babies screened in 10 units over a year, 127 (17.6%) developed any ROP; and 29 (22.8%) developed type 1 ROP. Only 13 (44.8%) babies were treated, most by intravitreal bevacizumab. The screening criteria were revised in 2020. Challenges included lack of equipment to regulate oxygen and to document and treat ROP, and lack of data systems.ConclusionROP screening coverage and quality improved after national and international collaborative efforts. To scale up and improve services, equipment for neonatal care and ROP treatment is urgently needed, as well as systems to monitor data. Ongoing advocacy is also essential.

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“…ROP is caused by impaired autoregulation of the retinal blood vessels and sudden postnatal oxygen tension. Retinal neovascularization in ROP cases involves angiogenic factors such as VEGF in preterm infants and VLBW infants [ 20 - 22 ]. Recent studies have reported that lower GA, lower birth weight, and excessive oxygen exposure are major risk factors for ROP [ 20 - 23 ].…”

Section: Discussionmentioning

confidence: 99%

Chronic Placental Inflammation as a Risk Factor of Severe Retinopathy of Prematurity

Kim

Jung

Kim

et al. 2018

J Pathol Transl Med

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BackgroundChronic placental inflammation (CPI) has been implicated in the pathogenesis of diseases in premature infants, whereas retinopathy of prematurity (ROP) is a major complication primarily affecting preterm and very low-birth-weight (VLBW) infants. This study aims to investigate the association between CPI and ROP in VLBW infants.MethodsWe performed a retrospective review of clinical records of VLBW infants born between 2013 and 2016. Placental pathology findings including CPI cases were analyzed using logistic regression to study infants’ morbidities and other clinical characteristics.ResultsA total of 402 infants with a mean (standard deviation) gestational age of 28.5 (2.8) weeks and birth weight of 1,027.2 (304.4) g were included. The incidence of ROP was 24.1%. CPI was found in 90 infants (22.4%), among which 28.9% (26 of 90) developed ROP, and 21.1% (19 of 90) underwent laser photocoagulation. Lower gestational age, lower birth weight, longer duration of oxygen supply, and presence of CPI were associated with the development of ROP. After adjustment for gestational age, birth weight, sex, duration of oxygen supply, and other overlapping placental pathology, CPI was associated with the odds for type 1 ROP that required laser photocoagulation (adjusted odds ratio, 2.739; 95% confidence interval, 1.112 to 6.749; p = .029).ConclusionsCPI was associated with severe ROP requiring treatment with laser photocoagulation in VLBW infants.

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Role of cytokines and treatment algorithms in retinopathy of prematurity

Cited by 14 publications

References 47 publications

Beyond sepsis: Staphylococcus epidermidis is an underestimated but significant contributor to neonatal morbidity

Beyond sepsis: Staphylococcus epidermidis is an underestimated but significant contributor to neonatal morbidity

Strengthening retinopathy of prematurity screening and treatment services in Nigeria: a case study of activities, challenges and outcomes 2017-2020

Chronic Placental Inflammation as a Risk Factor of Severe Retinopathy of Prematurity

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