Objective To explore the role of the base mismatch repair gene Mutyh in retinopathy of prematurity(ROP). Methods Mutyh(-/-)and wild-type(WT)mice were used for the modeling of oxygen-induced retinopathy.The retinal oxidative stress was examined,and the ultrastructures of photoreceptors and mitochondria were observed.The biomarkers of photoreceptors and mitochondria were tested.Furthermore,the photoreceptor cell line 661W was treated with hydrogen peroxide for the modeling of oxidative stress.In the cell model,and the oxidative stress and photoreceptor functions in the cells were measured. Results In both the mouse and cell models,the expression of Mutyh was up-regulated.Mutyh knockout in mice and knockdown in cells exerted negative effects on photoreceptors and mitochondria.Mutyh overexpression showed protective functions in the cell model,indicating that Mutyh played a role in repairing photoreceptors and mitochondria. Conclusions Mutyh showed the potential to become a biomarker of ROP.Increasing Mutyh expression might have therapeutic effects on ROP,which needs further validation.
Oxidative Stress ; Animals ; Mice ; DNA Glycosylases/metabolism* ; Retinopathy of Prematurity/etiology* ; Mice, Knockout ; Disease Models, Animal ; Humans ; Mitochondria/metabolism*

OBJECTIVETo investigate the importance of breastfeeding in preterm infants with various gestational ages.

METHODSA total of 639 preterm infants with a gestational age of 28-36weeks were enrolled, and according to the feeding pattern, they were divided into exclusive breastfeeding group (n=237) and formula milk feeding group (fed with liquid milk for preterm infants; n=402). These two feeding patterns were compared in terms of their effects on weight gain, laboratory markers including albumin (Alb) and alkaline phosphatase (ALP), incidence rate of feeding intolerance, and incidence rates of complications including necrotizing enterocolitis (NEC) and retinopathy of prematurity (ROP).

RESULTSCompared with the formula milk feeding group, the breastfeeding group had a significantly faster increase in body weight, a significantly lower incidence rate of NEC, a significantly higher ALP level, and a significantly lower Alb level in the preterm infants with a gestational age of 28-30 weeks (P<0.05); there were no significant differences between the two groups in the incidence rates of anemia, ROP, bronchopulmonary dysplasia (BPD), and nosocomial infection and length of hospital stay (P>0.05). For the preterm infants with a gestational age of 31-33 weeks, the breastfeeding group had a significantly faster increase in body weight, a significantly lower incidence rate of feeding intolerance, a significantly shorter length of hospital stay, and a significantly higher ALP level (P<0.05); there were no significant differences between the two groups in the incidence rates of NEC, anemia, ROP, BPD, and nosocomial infection and the Alb level (P>0.05). For the preterm infants with a gestational age of 34-36 weeks, there were no significant differences in these indices between the two groups (P>0.05).

CONCLUSIONSBreastfeeding plays an important role in increasing body weight, reducing the incidence rates of feeding intolerance and NEC, and shortening the length of hospital stay in preterm infants with a gestational age of 28-33 weeks.

Breast Feeding ; Bronchopulmonary Dysplasia ; etiology ; Enterocolitis, Necrotizing ; etiology ; Humans ; Infant Formula ; Infant, Newborn ; Infant, Premature ; Intensive Care Units, Neonatal ; Retinopathy of Prematurity ; etiology

OBJECTIVETo explore an optimal oxygen saturation for extremely preterm infants based on a systemic review of the published studies.

METHODSA Meta analysis of the published studies by the NeOProM Group which compared the outcomes of extremely preterm infants (gestational age <28 weeks) maintained in either a low (85%-89%) or high (91%-95%) oxygen saturation (SpO2) by using the STATA 12.0. The outcomes measured included the mortality and the incidences of retinopathy of prematurity (ROP), necrotizing enterocolitis of newborn (NEC), broncho-pulmonary dysplasia (BPD), intraventricular hemorrhage (IVH) and patent ductus arteriosus (PDA).

RESULTSThree studies were included, in which 2 460 infants were assigned into the low SpO2 group and 2 459 infants in the high SpO2 group. The Meta analysis demonstrated that the risk of mortality before discharge or at the age of 18 months increased in the low SpO2 group compared with the high SpO2 group (RR: 1.19; 95%CI: 1.05-1.35); the risk of ROP decreased in the low SpO2 group (RR: 0.73; 95%CI: 0.53-1.00); the risk of NEC increased in the low SpO2 group (RR: 1.26; 95%CI: 1.06-1.49). There was no significance in the incidences of BPD, IVH and PDA between the two groups.

CONCLUSIONSMaintaining SpO2 at 85%-89% may decrease the incidence of ROP, but increase the mortality rate and the incidence of NEC in extremely premature infants.

Enterocolitis, Necrotizing ; etiology ; Humans ; Infant ; Infant Mortality ; Infant, Extremely Premature ; metabolism ; Outcome Assessment (Health Care) ; Oxygen ; blood ; Retinopathy of Prematurity ; etiology

OBJECTIVETo determine the prevalence and risk factors of retinal diseases of preterm infants and full term for newborns small gestational age born (SGA) by using wide-angle digital retinal imaging system (RetCam3).

METHODSClinical data of 779 preterm and SGA infants whose eyes were detected by RetCam3 between January and December 2013 before discharge were studied retrospectively.

RESULTSAmong the 779 infants, there were 69 cases of retinal hemorrhage (8.9%), 10 cases (1.3%) of retinopathy of prematurity (ROP), 9 cases of retinal exudative changes, 4 cases of retinal myelinated nerve fibers, 2 cases of congenita cataract, 3 cases of retinal chromatosis, 2 cases of retinal crystalline changes and 1 case of retinoblastoma. Logistic regression analysis indicated that low birth weight and gestational age and the history of oxygen inhalation were risk factors for the development of ROP and that vaginal delivery and mechanical ventilation increased the risk of retinal hemorrhage.

CONCLUSIONSNeonatal fundus diseases may be so various and harmful that early fundus screening should be carried out on high-risk infants, such as preterm and SAG infants. Preventive measures should be taken against the risk factors for fundus diseases.

Birth Weight ; Female ; Fundus Oculi ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Premature ; Male ; Neonatal Screening ; Retinal Hemorrhage ; diagnosis ; etiology ; Retinopathy of Prematurity ; diagnosis ; etiology ; Risk Factors

Aggressive posterior retinopathy of prematurity (AP-ROP) is a special kind of ROP, which is characterized by ill-defined, dilated and tortuous vessels in the posterior portion of the eye and rapidly progresses to severe ROP with retinal detachment. As more and more AP-ROP cases, who usually have poor prognosis, have been found, this disease has been increasingly noted. Which premature infants are at risks? How to make earlier diagnosis? Is there any better treatment protocols? There is much research about AP-ROP and this article summarizes the risks, screening, diagnosis and treatment of this disease.
Humans ; Infant, Newborn ; Prognosis ; Retinopathy of Prematurity ; epidemiology ; etiology ; therapy

A 6-year-old boy was referred to our hospital with symblepharon and lateral canthal deformity in both eyes, which developed 6 years ago. The patient was born at 27 weeks gestation. He had received cryotherapy for retinopathy of prematurity. One month after cryotherapy, he developed a conjunctival scar with symblepharon in both eyes and underwent symblepharon lysis at another hospital 5 years prior. Ocular examination revealed an extensive conjunctival hypertrophic scar with symblepharon and limitation of extraocular movements. An excisional biopsy, lateral canthoplasty, and symblepharon lysis with conjunctival autograft from the contralateral eye were performed in the left eye. Histopathologic examination revealed diffuse proliferation and infiltration of collagenous tissue.
Biopsy ; Child ; Cicatrix, Hypertrophic/diagnosis/*etiology ; Conjunctiva/pathology ; Conjunctival Diseases/diagnosis/*etiology ; Cryotherapy/*adverse effects ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Male ; Retinopathy of Prematurity/*therapy

PURPOSE: Bell's phenomenon (BP), which may disturb screening examinations for retinopathy of prematurity (ROP), is known to present infrequently in premature babies. Stress associated with the examinations can influence expression of BP. The authors of the present study evaluated BP during examinations for ROP. METHODS: The present study included 102 eyes of 51 premature babies. Expression of BP was assessed at 3 steps of the examination in the following order: after insertion of a speculum, after illumination of an indirect ophthalmoscope and after scleral depression. The relationship between the expression of BP and the gestational age at the examination was analyzed in each step of the examination. RESULTS: The frequency of BP after the speculum insertion and the illumination was 77% to 92% in infants 32 weeks of age or younger, and decreased significantly to 16% to 57% in infants 42 weeks of age or older (p < 0.005). BP after the scleral depression had no significant association with the gestational age. Frequency of BP increased significantly as the steps of the examination proceeded (p < 0.01). CONCLUSIONS: BP was frequent in premature infants during ROP examination in spite of neurological immaturity. The examiner should take BP into consideration, which frequently occurs in younger infants.
Gestational Age ; Humans ; Incidence ; Infant, Newborn ; *Infant, Premature ; Korea/epidemiology ; Mass Screening/adverse effects/*methods/psychology ; Ophthalmoscopy/*psychology ; Retinopathy of Prematurity/*diagnosis/epidemiology ; Retrospective Studies ; Risk Factors ; Stress, Psychological/*epidemiology/etiology ; Vision Screening/adverse effects/*psychology

BACKGROUNDThe control of blindness in children is a high priority within the VISION 2020 initiative. To determine the causes of severe visual impairment and blindness in children from Shanghai Blind Children School (SBCS) can provide useful information on childhood blindness in Shanghai.

METHODSA cross-sectional investigation of students in SBCS was conducted in May 2010. The World Health Organization/Prevention of Blindness (WHO/PBL) eye examination record system for children with low vision and blindness was used. The results were further compared with the findings of two previous investigation studies conducted in 1986 and 2004, respectively in SBCS.

RESULTSOf the 146 children observed, 80 children (54.8%) were blind (best corrected best visual acuity less than 0.05), 27 children (18.5%) had severe visual impairment (best corrected visual acuity less than 0.1 but better than or equal to 0.05), and 34 children (23.3%) had moderate visual impairment (best corrected visual acuity less than 0.3 but better than or equal to 0.1). The major affected anatomic sites in the 107 children with severe visual impairment and blindness (SVI/BL) were retina (47.7%), whole globe (16.8%), optic nerve (13.1%) and lens (9.3%). The leading causes of SVI/BL were retinopathy of prematurity (ROP, 25.2%), followed by retinal dystrophy (15.9%), optic nerve atrophy (9.3%) and microphthalmos (9.3%). The two leading etiologic categories of SVI/BL were perinatal/neonatal (36.4%) and congenital/hereditary groups (29.0%). The leading cause of moderate visual impairment was aphakia after cataract surgery (congenital cataract, 44.1%). Compared with the findings in two previous investigations in SBCS, the proportion of ROP in visual impairing diseases increased, while the proportion of disorders of the lens (cataract and aphakia) significantly decreased.

CONCLUSIONSThe leading cause of childhood blindness in SBCS nowadays is ROP. It is projected that without improvement in perinatal medical care that ROP will continue to be a major cause of childhood blindness.

Adolescent ; Child ; Child, Preschool ; China ; Cross-Sectional Studies ; Female ; Humans ; Infant, Newborn ; Male ; Retinopathy of Prematurity ; complications ; Vision Disorders ; etiology

OBJECTIVETo evaluate the incidence and risk factors for severe retinopathy of prematurity (ROP) in preterm infants.

METHODSBetween May, 2008 and May, 2011, a total of 957 preterm infants at 4-6 weeks of chronological age or 32 weeks of postmenstrual age underwent retinal evaluation by RetCamII in our center, and the data of infants with ROP in any stage were analyzed.

RESULTSAmong the 957 preterm infants, we found 86 (8.99%) infants to have ROP in different stages, including 60 (6.27%) with mild ROP and 26 (2.72%) with severe ROP. The birth weight and gestational age of the infants with severe ROP averaged 1 420.40∓328.64 g and 29.88∓1.67 weeks, as compared to 1 593.28∓339.30 g and 31.78∓2.53 weeks in those with mild ROP, respectively, showing a significant difference between the two groups (P<0.005). The significant variables for severe ROP included gestational age (P=0.001), birth weight (P=0.035), 1 min Apgar score (P=0.001), 5 min Apgar score (P=0.005), number of blood transfusions (P=0.032), and the presence of apnea (P=0.04) and retinal hemorrhage (P=0.000). Gestational age and retinal hemorrhage were the independent risk factors for severe ROP (OR=0.353, 95%CI 0.163-0.763, P=0.008; OR=26.133, 95%CI 3.042-224.501, P=0.035).

CONCLUSIONSevere ROP tends to have a decreasing incidence and occurs more often in more mature preterm infants. The affected infants have the characteristics of the first epidemics. Gestational age and retinal hemorrhage are independent predictive factors for severe ROP.

Birth Weight ; China ; epidemiology ; Female ; Gestational Age ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Logistic Models ; Male ; Neonatal Screening ; Retinal Hemorrhage ; complications ; Retinopathy of Prematurity ; epidemiology ; etiology ; Retrospective Studies ; Risk Factors

OBJECTIVETo investigate the role of oxidative stress in the pathogenesis of retinal injury induced by hyperoxia.

METHODSSixty immature Sprague-Dawley (SD) rats born at a gestational age of 21 days, were randomly exposed to room air (air group, n=30) or 95% oxygen (hyperoxia group, n=30) immediately after birth. Plasma 8-iso-prostaglandin F2alpha (8-iso-PGF2alpha) levels were determined by ELISA. The ultrastructures of the retina were observed under a transmission electron microscope.

RESULTSThe plasma 8-iso-PGF2alpha contents of the air group were 19.09 +/-5.57, 18.24+/-5.91 and 17.00 +/- 5.58 pg/mL on the 3rd, 7th and 14th days after birth, respectively (F=1.024, P> 0.05). The plasma 8-iso-PGF2 contents in the hyperoxia group on the 3rd (28.33 +/- 5.59 pg/mL), the 7th day (51.20 +/- 15.01 pg/mL) and 14th day (84.54 +/- 14.85 pg/mL) after birth were significantly higher than those of the air group (t=2.863, P< 0.05; t=5.073, P< 0.01; t=11.006, P< 0.01). Moreover, the plasma 8-iso-PGF2 contents in the hyperoxia group increased with the prolonged hyperoxia exposure (F=150.7, P < 0.01). The ultrastructures of retina in the air group were normal. Hyperoxia exposure resulted in abnormalities of the ultrastructures of retina, manifesting as the membrane discs rarefied, twisted and disrupted and mitochondrial swelling.

CONCLUSIONSOxidative stress can results in retinal injury in immature rats. An increased plasma level of 8-iso-PGF2alpha is related to the injury degree of retina.

Animals ; Dinoprost ; analogs & derivatives ; blood ; Humans ; Hyperoxia ; complications ; metabolism ; pathology ; Infant, Newborn ; Lipid Peroxidation ; Oxidative Stress ; Rats ; Rats, Sprague-Dawley ; Retina ; metabolism ; pathology ; ultrastructure ; Retinopathy of Prematurity ; etiology