1
|
Hartnett ME, Stahl A. Laser versus Anti-VEGF: A Paradigm Shift for Treatment-Warranted Retinopathy of Prematurity. Ophthalmol Ther 2023; 12:2241-2252. [PMID: 37337024 PMCID: PMC10442041 DOI: 10.1007/s40123-023-00744-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 05/23/2023] [Indexed: 06/21/2023] Open
Abstract
Retinopathy of prematurity (ROP), a leading cause of childhood blindness, has historically been associated with blindness from overgrowth of blood vessels from the retina into the vitreous that lead to complex retinal detachments. Our understanding of ROP has evolved with the survival of extremely low-birthweight infants and includes not only overgrowth of blood vessels, but also insufficient developmental retinal vascular growth in early phases of the disease. Our current treatments of ROP have focused on methods to improve perinatal and prenatal care, reduce premature birth, and prevent early phases of ROP. Nonetheless, addressing vasoproliferation in treatment-warranted eyes remains the mainstay of management. Two main treatment strategies co-exist today: laser treatment, which has been the standard of care since the 1990s, and anti-VEGF injections, which have been used since early reports in 2007 (Travassos et al. in Ophthalmic Surg Lasers Imaging, 38:233-237, https://doi.org/10.3928/15428877-20070501-09 , 2007, Shah et al. in Indian J Ophthalmol 55:75-76, https://doi.org/10.4103/0301-4738.29505 , 2007, Quiroz-Mercado et al. in Semin Ophthalmol 22:109-125, https://doi.org/10.1080/08820530701420082 , 2007).
Collapse
Affiliation(s)
- M. Elizabeth Hartnett
- Byers Eye Institute at Stanford University, Stanford University, 2452 Watson Court, Palo Alto, CA 94303 USA
| | - Andreas Stahl
- Chair for Ophthalmology, University Medicine Greifswald, Germany, Ferdinand Sauerbruch Strasse, 17475 Greifswald, Germany
| |
Collapse
|
2
|
Balázs G, Balajthy A, Seri I, Hegyi T, Ertl T, Szabó T, Röszer T, Papp Á, Balla J, Gáll T, Balla G. Prevention of Chronic Morbidities in Extremely Premature Newborns with LISA-nCPAP Respiratory Therapy and Adjuvant Perinatal Strategies. Antioxidants (Basel) 2023; 12:1149. [PMID: 37371878 DOI: 10.3390/antiox12061149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/22/2023] [Accepted: 05/22/2023] [Indexed: 06/29/2023] Open
Abstract
Less invasive surfactant administration techniques, together with nasal continuous airway pressure (LISA-nCPAP) ventilation, an emerging noninvasive ventilation (NIV) technique in neonatology, are gaining more significance, even in extremely premature newborns (ELBW), under 27 weeks of gestational age. In this review, studies on LISA-nCPAP are compiled with an emphasis on short- and long-term morbidities associated with prematurity. Several perinatal preventative and therapeutic investigations are also discussed in order to start integrated therapies as numerous organ-saving techniques in addition to lung-protective ventilations. Two thirds of immature newborns can start their lives on NIV, and one third of them never need mechanical ventilation. With adjuvant intervention, these ratios are expected to be increased, resulting in better outcomes. Optimized cardiopulmonary transition, especially physiologic cord clamping, could have an additively beneficial effect on patient outcomes gained from NIV. Organ development and angiogenesis are strictly linked not only in the immature lung and retina, but also possibly in the kidney, and optimized interventions using angiogenic growth factors could lead to better morbidity-free survival. Corticosteroids, caffeine, insulin, thyroid hormones, antioxidants, N-acetylcysteine, and, moreover, the immunomodulatory components of mother's milk are also discussed as adjuvant treatments, since immature newborns deserve more complex neonatal interventions.
Collapse
Affiliation(s)
- Gergely Balázs
- Department of Pediatrics, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - András Balajthy
- Department of Pediatrics, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - István Seri
- First Department of Pediatrics, School of Medicine, Semmelweis University, 1083 Budapest, Hungary
- Keck School of Medicine of USC, Children's Hospital of Los Angeles, Los Angeles, CA 90033, USA
| | - Thomas Hegyi
- Department of Pediatrics, Division of Neonatology, Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, New Brunswick, NJ 08903, USA
| | - Tibor Ertl
- Departments of Neonatology and Obstetrics & Gynecology, University of Pécs Medical School, 7624 Pécs, Hungary
- MTA-PTE Human Reproduction Scientific Research Group, University of Pécs, 7624 Pécs, Hungary
| | - Tamás Szabó
- Department of Pediatrics, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - Tamás Röszer
- Department of Pediatrics, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - Ágnes Papp
- Department of Pediatrics, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - József Balla
- Department of Internal Medicine, Division of Nephrology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
- ELKH-UD Vascular Pathophysiology Research Group, Hungarian Academy of Sciences, University of Debrecen, 4032 Debrecen, Hungary
| | - Tamás Gáll
- Department of Internal Medicine, Division of Nephrology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - György Balla
- Department of Pediatrics, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
- ELKH-UD Vascular Pathophysiology Research Group, Hungarian Academy of Sciences, University of Debrecen, 4032 Debrecen, Hungary
| |
Collapse
|
4
|
Kumar VHS. Is Anti-Vascular Growth Factor Therapy for Retinopathy of Prematurity Associated With Pulmonary Hypertension? JAMA Ophthalmol 2023; 141:407-408. [PMID: 36862405 DOI: 10.1001/jamaophthalmol.2023.0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Affiliation(s)
- Vasantha H S Kumar
- Center for Developmental Biology of the Lung, Department of Pediatrics, University at Buffalo, Buffalo, New York
| |
Collapse
|
5
|
Chiang PH, Lin CC. Is Anti-Vascular Growth Factor Therapy for Retinopathy of Prematurity Associated With Pulmonary Hypertension? JAMA Ophthalmol 2023; 141:407. [PMID: 36862391 DOI: 10.1001/jamaophthalmol.2023.0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Affiliation(s)
- Ping-Hao Chiang
- Chung Shan Medical University Hospital, Taichung City, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung City, Taiwan
| | - Ching-Chieh Lin
- Chung Shan Medical University Hospital, Taichung City, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung City, Taiwan
| |
Collapse
|
6
|
Nitkin CR, Richardson T, Lewis T. Is Anti-Vascular Growth Factor Therapy for Retinopathy of Prematurity Associated With Pulmonary Hypertension?-Reply. JAMA Ophthalmol 2023; 141:408-409. [PMID: 36862400 DOI: 10.1001/jamaophthalmol.2023.0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Affiliation(s)
- Christopher R Nitkin
- Division of Neonatology, Department of Pediatrics, Children's Mercy Kansas City, University of Missouri Kansas City School of Medicine, Kansas City
| | | | - Tamorah Lewis
- The Hospital for Sick Children, Divisions of Clinical Pharmacology & Toxicology and Neonatology, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
7
|
Raghuveer TS, Zackula RE, Okut H. Is Anti-Vascular Growth Factor Therapy for Retinopathy of Prematurity Associated With Pulmonary Hypertension? JAMA Ophthalmol 2023; 141:406-407. [PMID: 36862404 DOI: 10.1001/jamaophthalmol.2023.0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Affiliation(s)
- Talkad S Raghuveer
- Department of Pediatrics, University of Kansas Medical School-Wichita, Wichita.,University of Kansas School of Medicine-Wichita
| | - Rosey E Zackula
- University of Kansas School of Medicine-Wichita.,Research Department, University of Kansas Medical School-Wichita
| | - Hayrettin Okut
- University of Kansas School of Medicine-Wichita.,Research Department, University of Kansas Medical School-Wichita
| |
Collapse
|
8
|
Patel SN. Pulmonary Hypertension and Anti-Vascular Endothelial Growth Factor Therapy for Retinopathy of Prematurity-Is There a Link? JAMA Ophthalmol 2022; 140:1094-1095. [PMID: 36201187 DOI: 10.1001/jamaophthalmol.2022.3824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Samir N Patel
- Mid Atlantic Retina, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania
| |
Collapse
|