早产儿视网膜病变:需要预防。

IF 3.1 Q1 OPHTHALMOLOGY
Eye and Brain Pub Date : 2016-05-20 eCollection Date: 2016-01-01 DOI:10.2147/EB.S99038
Raffael Liegl, Ann Hellström, Lois Eh Smith
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引用次数: 36

摘要

在美国,每年有超过45万婴儿早产。即使是最脆弱的低体重早产儿存活率的提高,尽管改善了健康结果,但导致早产并发症的重新出现,包括导致儿童失明的主要原因之一,早产儿视网膜病变。目前主要的ROP治疗方法是激光光凝和在疾病晚期新血管形成后注射血管内皮生长因子(VEGF)抗体。这两种方法都是眼科医生治疗晚期严重ROP的有效方法。然而,激光光凝会破坏视网膜的主要部分,而注射VEGF抗体虽然操作简单,但可能导致正常血管形成的全身抑制,这方面的研究还不够深入。然而,无论是使用VEGF抗体还是激光治疗都不能预防ROP,这应该是长期的目标。通过更密切地模仿早产后的宫内环境,应该可以预防ROP。这些预防措施包括预防产后毒性影响(例如,氧气过量)以及提供缺失的宫内因子(例如,胰岛素生长因子1),并可能减少早产的其他并发症以及ROP。本综述旨在总结目前关于预防ROP的知识,特别强调补充胰岛素生长因子1的使用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Retinopathy of prematurity: the need for prevention.

Retinopathy of prematurity: the need for prevention.

Retinopathy of prematurity: the need for prevention.

More than 450,000 babies are born prematurely in the USA every year. The improved survival of even the most vulnerable low body weight preterm infants has, despite improving health outcomes, led to the resurgence in preterm complications including one of the major causes for blindness in children, retinopathy of prematurity (ROP). The current mainstay in ROP therapy is laser photocoagulation and the injection of vascular endothelial growth factor (VEGF) antibodies in the late stages of the disease after the onset of neovascularization. Both are proven options for ophthalmologists to treat the severe forms of late ROP. However, laser photocoagulation destroys major parts of the retina, and the injection of VEGF antibodies, although rather simple to administer, may cause a systemic suppression of normal vascularization, which has not been studied in sufficient depth. However, the use of neither VEGF antibody nor laser treatment prevents ROP, which should be the long-term goal. It should be possible to prevent ROP by more closely mimicking the intrauterine environment after preterm birth. Such preventive measures include preventing the toxic postbirth influences (eg, oxygen excess) as well as providing the missing intrauterine factors (eg, insulin growth factor 1) and are likely to also reduce other complications of premature birth as well as ROP. This review is meant to summarize the current knowledge on the prevention of ROP with a particular emphasize on the use of insulin growth factor 1 supplementation.

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来源期刊
Eye and Brain
Eye and Brain OPHTHALMOLOGY-
CiteScore
7.90
自引率
2.30%
发文量
12
审稿时长
16 weeks
期刊介绍: Eye and Brain is an international, peer-reviewed, open access journal focusing on basic research, clinical findings, and expert reviews in the field of visual science and neuro-ophthalmology. The journal’s unique focus is the link between two well-known visual centres, the eye and the brain, with an emphasis on the importance of such connections. All aspects of clinical and especially basic research on the visual system are addressed within the journal as well as significant future directions in vision research and therapeutic measures. This unique journal focuses on neurological aspects of vision – both physiological and pathological. The scope of the journal spans from the cornea to the associational visual cortex and all the visual centers in between. Topics range from basic biological mechanisms to therapeutic treatment, from simple organisms to humans, and utilizing techniques from molecular biology to behavior. The journal especially welcomes primary research articles or review papers that make the connection between the eye and the brain. Specific areas covered in the journal include: Physiology and pathophysiology of visual centers, Eye movement disorders and strabismus, Cellular, biochemical, and molecular features of the visual system, Structural and functional organization of the eye and of the visual cortex, Metabolic demands of the visual system, Diseases and disorders with neuro-ophthalmic manifestations, Clinical and experimental neuro-ophthalmology and visual system pathologies, Epidemiological studies.
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