| 1. |
- Klevebro, S, et al.
(författare)
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Cohort study of growth patterns by gestational age in preterm infants developing morbidity.
- 2016
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Ingår i: BMJ Open. - London, UK : BMJ. - 2044-6055. ; 6:11
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Tidskriftsartikel (refereegranskat)abstract
- To examine differences in growth patterns in preterm infants developing major morbidities including retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD), necrotising enterocolitis (NEC) and intraventricular haemorrhage (IVH).Cohort study of 2521 infants born at a gestational age (GA) of 23-30weeks from 11 level III neonatal intensive care units in USA and Canada, and 3 Swedish population-based cohorts.Birth weight and postnatal weight gain were examined relative to birth GA and ROP, BPD, NEC and IVH development.Among infants with a birth GA of 25-30weeks, birth weight SD score and postnatal weight were lower in those developing ROP and BPD. Infants developing ROP showed lower growth rates during postnatal weeks 7-9 in the 23-24weeks GA group, during weeks 4-6 in the 25-26weeks GA group and during weeks 1-5 in the 27-30weeks GA group. Infants with BPD born at 27-30weeks GA showed lower growth rates during postnatal weeks 3-5. Infants with NEC had lower growth rates after postnatal week 6 in all GA groups, with no significant differences in birth weight SD score. IVH was not associated with prenatal or postnatal growth.In this cohort study of extremely preterm infants, we found that the postnatal growth pattern was associated with morbidities such as ROP, BPD and NEC as well as with gestational age at birth.
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| 2. |
- Sun, H. Q., et al.
(författare)
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The Use of the WINROP Screening Algorithm for the Prediction of Retinopathy of Prematurity in a Chinese Population
- 2013
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Ingår i: Neonatology. - : S. Karger AG. - 1661-7800 .- 1661-7819. ; 104:2, s. 127-132
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Tidskriftsartikel (refereegranskat)abstract
- Background: Retinopathy of prematurity (ROP) is a gestational age (GA)-related illness that can lead to blindness in premature infants. Timely screening of premature infants could improve visual prognosis. Objective: To evaluate the WINROP algorithm as a method of predicting severe ROP in a Chinese population. Methods: 590 infants with a GA <32 weeks were entered into an online surveillance system (www.winrop.com) that included ROP evaluations and weekly weight measurements from birth to a corrected GA of 40 weeks. If the rate of weight gain decreased to a certain degree, the algorithm signaled an alarm that the infant was at risk for developing sight-threatening ROP. Each infant was categorized as having no, mild, or severe ROP. Results: Among the 590 infants with a GA <32 weeks, an alarm was triggered in 85 infants (14.4%), 50 of which developed severe ROP and were identified in this alarm group. Twenty-seven infants triggered the alarm signal in the first week after birth and 7 infants triggered the alarm at birth. Seven of the infants developed proliferative ROP and the median GA at birth for these infants was 31 weeks. Conclusions: The WINROP system had a sensitivity of 87.5% in a Chinese population for the early identification of infants that developed severe ROP. Postnatal weight gain may help predict ROP in lower birth weight infants. Copyright (C) 2013 S. Karger AG, Basel
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| 3. |
- Cakir, B., et al.
(författare)
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IGF1, serum glucose, and retinopathy of prematurity in extremely preterm infants
- 2020
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Ingår i: Jci Insight. - : American Society for Clinical Investigation. - 2379-3708. ; 5:19
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND. Hyperglycemia, insulin insensitivity, and low IGF1 levels in extremely preterm infants are associated with an increased risk of retinopathy of prematurity (ROP), but the interactions are incompletely understood. METHODS. In 117 extremely preterm infants, serum glucose levels and parenteral glucose intake were recoded daily in the first postnatal week. Serum IGF1 levels were measured weekly. Mice with oxygen-induced retinopathy alone versus oxygen-induced retinopathy plus streptozotocin-induced hyperglycemia/hypoinsulinemia were assessed for glucose, insulin, IGF1, IGFBP1, and IGFBP3 in blood and liver. Recombinant human IGF1 was injected to assess the effect on glucose and retinopathy. RESULTS. The highest mean plasma glucose tertile of infants positively correlated with parenteral glucose intake [r (39) = 0.67, P < 0.0001]. IGF1 plasma levels were lower in the high tertile compared with those in low and intermediate tertiles at day 28 (P = 0.038 and P = 0.03). In high versus lower glucose tertiles, ROP was more prevalent (34 of 39 versus 19 of 39) and more severe (ROP stage 3 or higher; 71% versus 32%). In oxygen-induced retinopathy, hyperglycemia/hypoinsulinemia decreased liver IGF1 expression (P < 0.0001); rh-IGF1 treatment improved normal vascular regrowth (P = 0.027) and reduced neovascularization (P < 0.0001). CONCLUSION. In extremely preterm infants, high early postnatal plasma glucose levels and signs of insulin insensitivity were associated with lower IGF1 levels and increased ROP severity. In a hyperglycemia retinopathy mouse model, decreased insulin signaling suppressed liver IGF1 production, lowered serum IGF1 levels, and increased neovascularization. IGF1 supplementation improved retinal revascularization and decreased pathological neovascularization. The data support IGF1 as a potential treatment for prevention of ROP.
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| 4. |
- Cakir, B., et al.
(författare)
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Thrombocytopenia is associated with severe retinopathy of prematurity
- 2018
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Ingår i: Jci Insight. - : American Society for Clinical Investigation. - 2379-3708. ; 3:19
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Tidskriftsartikel (refereegranskat)abstract
- Retinopathy of prematurity (ROP) is characterized by abnormal retinal neovascularization in response to vessel loss. Platelets regulate angiogenesis and may influence ROP progression. In preterm infants, we assessed ROP and correlated with longitudinal postnatal platelet counts (n = 202). Any episode of thrombocytopenia (< 100 x 10(9)/l) at >= 30 weeks postmenstrual age (at onset of ROP) was independently associated with severe ROP, requiring treatment. Infants with severe ROP also had a lower weekly median platelet count compared with infants with less severe ROP. In a mouse oxygen-induced retinopathy model of ROP, platelet counts were lower at P17 (peak neovascularization) versus controls. Platelet transfusions at P15 and P16 suppressed neovascularization, and platelet depletion increased neovascularization. Platelet transfusion decreased retinal of vascular endothelial growth factor A (VEGFA) mRNA and protein expression; platelet depletion increased retinal VEGFA mRNA and protein expression. Resting platelets with intact granules reduced neovascularization, while thrombin-activated degranulated platelets did not. These data suggest that platelet releasate has a local antiangiogenic effect on endothelial cells to exert a downstream suppression of VEGFA in neural retina. Low platelet counts during the neovascularization phase in ROP is significantly associated with the development of severe ROP in preterm infants. In a murine model of retinopathy, platelet transfusion during the period of neovascularization suppressed retinopathy.
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| 5. |
- Choi, J. H., et al.
(författare)
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Efficacy of the Screening Algorithm WINROP in a Korean Population of Preterm Infants
- 2013
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Ingår i: Jama Ophthalmology. - 2168-6165. ; 131:1, s. 62-66
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Tidskriftsartikel (refereegranskat)abstract
- Objective To investigate the efficacy of WINROP (https://winrop.com), an algorithm based on serial measurements of neonatal body weight to predict proliferative retinopathy of prematurity (ROP), in a Korean population of preterm infants. Methods The records of preterm infants with gestational age less than 32 weeks who were admitted to the neonatal intensive care unit at Chonnam National University Hospital, Gwangju, South Korea, from October 2006 to November 2010 were reviewed. The body weight of infants was measured weekly and entered into a computer-based surveillance system, WINROP, and the outcome was analyzed. Results A total of 314 preterm infants participated in the study. The mean gestational age was 29 weeks (range, 25-32 weeks). The mean body weight was 1263 g (range, 590-2260 g). For 166 of 314 infants (52.9%), a high-risk alarm was noted. In the high-risk alarm group, 36 infants developed type 1 ROP, according to the Early Treatment for Retinopathy of Prematurity criteria, and they were treated for ROP. The remaining 148 infants (47.1%) had a low-risk alarm. In the low-risk alarm group, 3 infants with bronchopulmonary dysplasia and intraventricular hemorrhage, a risk factor for ROP, and 1 infant without any risk factors for ROP developed type 1 ROP and were treated. Conclusions In a Korean population, the WINROP algorithm had a sensitivity of 90% for identifying infants with type 1 ROP. Although some limitations are present, adjustment to the WINROP algorithm for a specific population may improve the efficacy of predicting proliferative ROP and reduce the frequency of retinal examinations.
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| 6. |
- Connor, K. M., et al.
(författare)
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Increased dietary intake of omega-3-polyunsaturated fatty acids reduces pathological retinal angiogenesis
- 2007
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Ingår i: Nat Med. - 1078-8956.
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Tidskriftsartikel (refereegranskat)abstract
- Many sight-threatening diseases have two critical phases, vessel loss followed by hypoxia-driven destructive neovascularization. These diseases include retinopathy of prematurity and diabetic retinopathy, leading causes of blindness in childhood and middle age affecting over 4 million people in the United States. We studied the influence of omega-3- and omega-6-polyunsaturated fatty acids (PUFAs) on vascular loss, vascular regrowth after injury, and hypoxia-induced pathological neovascularization in a mouse model of oxygen-induced retinopathy. We show that increasing omega-3-PUFA tissue levels by dietary or genetic means decreased the avascular area of the retina by increasing vessel regrowth after injury, thereby reducing the hypoxic stimulus for neovascularization. The bioactive omega-3-PUFA-derived mediators neuroprotectinD1, resolvinD1 and resolvinE1 also potently protected against neovascularization. The protective effect of omega-3-PUFAs and their bioactive metabolites was mediated, in part, through suppression of tumor necrosis factor-alpha. This inflammatory cytokine was found in a subset of microglia that was closely associated with retinal vessels. These findings indicate that increasing the sources of omega-3-PUFA or their bioactive products reduces pathological angiogenesis. Western diets are often deficient in omega-3-PUFA, and premature infants lack the important transfer from the mother to the infant of omega-3-PUFA that normally occurs in the third trimester of pregnancy. Supplementing omega-3-PUFA intake may be of benefit in preventing retinopathy.
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| 7. |
- Eriksson, L., et al.
(författare)
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WINROP can modify ROP screening praxis: a validation of WINROP in populations in Sormland and Vastmanland
- 2014
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Ingår i: British Journal of Ophthalmology. - : BMJ. - 0007-1161 .- 1468-2079. ; 98:7, s. 964-966
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Tidskriftsartikel (refereegranskat)abstract
- Background This study validates the newly developed WINROP algorithm aimed at detecting retinopathy of prematurity (ROP) requiring treatment at an early stage. The study was conducted at two middle-sized hospitals in Sweden, prospectively and retrospectively. Methods A total of 104 children participated in this study. Their mean gestational age at birth was 28.7 weeks (range, 23.6-32.1 weeks), and their mean birth weight was 1208 g (range, 477-2340 g). Weekly weight measurements were used in WINROP to calculate the risk of developing ROP. Results 80% of infants (83/104) had no ROP, 15% (16/104) had mild ROP (stage 1 or 2), 5% (5/104) had severe ROP, and 2% (2/104) were treated for ROP. The alarm was registered at an average of 2 weeks postnatal age (range 1-6 weeks). Conclusions WINROP identified all the infants at risk for developing stage 3 ROP (100% sensitivity) and had a 59% specificity. The alarm was registered several weeks before screening for ROP began. WINROP can be used to complement conventional ROP screening.
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| 8. |
- Fluckiger, S., et al.
(författare)
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[The early postnatal weight gain as a predictor of retinopathy of prematurity] : Der frühe postnatale Gewichtsverlauf als Prädiktor einer Frühgeborenenretinopathie
- 2011
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Ingår i: Klinische Monatsblätter für Augenheilkunde. - 1439-3999. ; 228:4, s. 306-10
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Premature infants are often stressed by the current retinopathy of prematurity (ROP) screening procedure. Additionally, only < 10 % of the screened infants will develop a ROP stadium requiring laser therapy. Therefore the present screening strategy is unsatisfactory. Furthermore, the current guidelines do not take into account postnatal factors. A new method considering postnatal factors is the weight, insulin-like growth factor, neonatal ROP (WINROP) algorithm. This approach is based on the early postnatal weight gain. The aim of this study was to assign the WINROP-algorithm to a preterm population in Switzerland and to analyze its ability for prediction. PATIENTS AND METHODS: In this retrospective study, all preterm infants with a gestational age (GA) < 32 weeks and/or a birth weight (BW)
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| 9. |
- Fu, Z. F., et al.
(författare)
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Review: adiponectin in retinopathy
- 2016
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Ingår i: Biochimica Et Biophysica Acta-Molecular Basis of Disease. - : Elsevier BV. - 0925-4439. ; 1862:8, s. 1392-1400
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Tidskriftsartikel (refereegranskat)abstract
- Neovascular eye diseases are a major cause of blindness including retinopathy of prematurity, diabetic retinopathy and age-related macular degeneration in which new vessel formation is driven by hypoxia or metabolic abnormalities affecting the fuel supply. White-adipose-tissue derived adipokines such as adiponectin modulate metabolic responses. Increasing evidence shows that lack of adiponectin may result in retinal neovascularization. Activation of the adiponectin pathway may in turn restore energy metabolism, to suppress the drive for compensatory but ultimately pathological neovessels of retinopathy. In this review, we will summarize our current knowledge of the role of adiponectin in eye diseases of premature infants, diabetic patients as well as the elderly. Further investigations in this field are likely to lead to new preventative approaches for these diseases. (C) 2016 Elsevier B.V. All rights reserved.
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| 10. |
- Fu, Z. J., et al.
(författare)
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Adiponectin Mediates Dietary Omega-3 Long-Chain Polyunsaturated Fatty Acid Protection Against Choroidal Neovascularization in Mice
- 2017
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Ingår i: Investigative Ophthalmology & Visual Science. - : Association for Research in Vision and Ophthalmology (ARVO). - 0146-0404 .- 1552-5783. ; 58:10, s. 3862-3870
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE. Neovascular age-related macular degeneration (AMD) is a major cause of legal blindness in the elderly. Diets with omega3-long-chain-polyunsaturated-fatty-acid (omega 3-LCPUFA) correlate with a decreased risk of AMD. Dietary omega 3-LCPUFA versus omega 6-LCPUFA inhibits mouse ocular neovascularization, but the underlying mechanism needs further exploration. The aim of this study was to investigate if adiponectin (APN) mediated x omega 3-LCPUFA suppression of neovessels in AMD. METHODS. The mouse laser-induced choroidal neovascularization (CNV) model was used to mimic some of the inflammatory aspect of AMD. CNV was compared between wild-type (WT) and Apn(-/-) mice fed either otherwise matched diets with 2% x3 or 2% omega 6-LCPUFAs. Vldlr(-/-) mice were used to mimic some of the metabolic aspects of AMD. Choroid assay ex vivo and human retinal microvascular endothelial cell (HRMEC) proliferation assay in vitro was used to investigate the APN pathway in angiogenesis. Western blot for p-AMPK alpha/AMPK alpha and qPCR for Apn, Mmps, and IL-10 were used to define mechanism. RESULTS. omega 3-LCPUFA intake suppressed laser-induced CNV in WT mice; suppression was abolished with APN deficiency. omega 3-LCPUFA, mediated by APN, decreased mouse Mmps expression. APN deficiency decreased AMPK alpha phosphorylation in vivo and exacerbated choroid-sprouting ex vivo. APN pathway activation inhibited HRMEC proliferation and decreased Mmps. In Vldlr(-/-) mice, omega 3-LCPUFA increased retinal AdipoR1 and inhibited NV. omega 3-LCPUFA decreased IL-10 but did not affect Mmps in Vldlr(-/-) retinas. CONCLUSIONS. APN in part mediated omega 3-LCPUFA inhibition of neovascularization in two mouse models of AMD. Modulating the APN pathway in conjunction with a omega 3-LCPUFA-enriched-diet may augment the beneficial effects of omega 3-LCPUFA in AMD patients.
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