ObjectiveTo detect the development of retinal neovascularization (NV) induced by metabolic acidosis in neonatal rats and investigate the relationship between the occurrence of NV and vascular endothelial growth factor (VEGF). MethodsA total of 425 newborn Sprague-Dawley rats in experimental group underwent tubal feeding of NH4Cl (535 mg/kg) with the concentration of (50 mg/ml) (twice per day) from the 2nd day after the birth for 6 days and followed by a period of recovery. Additional 150 neonatal rats were in the control group without the tubal feeding. The rats were executed at the 3rd, 5th, 8th, 10th, 13th, 20th day after birth respectively. The retinal vessels were evaluated through retinal stretched preparation andadenosine diphosphatase (ADPase) staining; VEGF in retina was detected by enzymelinked immunosorbent assay(ELISA).ResultsIn the experimental group, the incidence of retinal NV at the 3rd, 5th, 8th, 10th, 13th, 20th day after birth was 0%，9%，26%，55%，19%, and 0% respectively. At the 3rd day, the expression of VEGF protein was lower in experimental group ［（101.1±14.2 ）pg/mg］ than that in the control group ［（133.2±15.9） pg/mg］（P＝0.004）, while at the 8th day it was higher in experimental group［(98.4±19.2) pg/mg］than that in the control group［（78.1±8.7） pg/mg］（P=0.028). There was no significant difference between the two groups at the 5th, 10th, 13th, and 20th day (Pgt;0.05). ConclusionsMetabolic acidosis may induce NV by injuring the developing retinal vessels. Retinal NV induced by acidosis relates to VEGF. (Chin J Ocul Fundus Dis, 2005,21:296-299)
早产儿视网膜病变（ROP）是儿童盲的重要致盲原因之一，随着ROP防治指南的颁布以及ROP筛查工作的开展，我国ROP发病率和致盲率有所下降。正确认识和理解ROP分类、筛查标准和治疗指南；建立完善的ROP筛查体系，提高筛查水平；加强ROP临床和基础研究，将有助于进一步降低我国ROP发病率和致盲率
ObjectiveTo observe and analyze the correlation between erythrocyte count and hemoglobin level in early life and retinopathy of prematurity (ROP). MethodsA clinical retrospective study. From January 2020 to December 2022, a total of 303 premature infants, who underwent fundus screening in Children's Hospital of Henan Province were included. There were 219 males and 84 females, with the average gestational age of (30.36±1.52) weeks and the average birth weight of (1 368.43±171.37) g. Early life was defined as 14 days after birth. According to the screening results, patients were divided into ROP group and no ROP group (control group). The results of red blood cell count, hematocrit and hemoglobin concentration of the two groups were compared and observed on the 3rd, 7th and 14th day after birth. The measurement data were compared by t-test, and the count data were compared by χ2 test. The risk factors of ROP were analyzed by logistic regression. The correlation between red blood cell count as well as hemoglobin concentration in early life and ROP was analyzed by receiver operating characteristics (ROC) curve. ResultsAmong the 303 premature infants screened, a total of 101 preterm infants were included in the ROP group, with the average gestational age of (30.39±1.48) weeks. And a total of 202 preterm infants were included in the control group, with the average gestational age of (30.35±1.55) weeks. There was no significant difference between the two groups in sex composition ratio (χ2=0.296) and gestational age (t=0.251) (P＞0.05). There were significant differences in birth weight (t=－2.024), blood transfusion times (U=－4.957), invasive mechanical ventilation duration (U=－2.215) and continuous positive airway pressure ventilation time (U=－5.224) between the two groups (P＜0.05). The incidence of periventricular leukomalacia (χ2=5.069), bronchopulmonary dysplasia (χ2=9.794) and sepsis (χ2=8.041) were significantly different (P＜0.05). The average hemoglobin level of patients in the ROP group on the 3rd, 7th and 14th day after birth were lower than those in the control group (t=－3.813, －2.753, －2.847; P＜0.05). Logistic regression analysis showed that low frequency of blood transfusion [odds ratio (OR)=1.241, 95% confidence interval (CI) 1.016-1.517] and short duration of continuous positive airway pressure (OR=1.128, 95%CI 1.031-1.234) were protective factors for ROP. The ROC curve analysis indicated that the abnormal threshold values of hematocrit and hemoglobin were the highest on the 14th day after birth, which were 115.5 g/L and 36.25% respectively. The sensitivities were 88.1% and 83.2%, respectively. ConclusionRed blood cell count and hemoglobin level in early life of preterm infants may have a certain correlation with the occurrence and development of ROP.
In the expert consensus published by the Pediatrics in 2013, it was first proposed that anti-VEGF drugs can be considered for retinopathy of prematurity (ROP) with stage 3, zone Ⅰ with plus disease. However, there are many problems worth the attention of ophthalmologists, including the advantages and disadvantages of anti-VEGF therapy compared with traditional laser therapy, systemic and ocular complications after anti-VEGF therapy, and what indicators are the end points of anti-VEGF therapy. Combined with this consensus and numerous research findings, we recommend that the first treatment for anti-VEGF or laser therapy should be considered from disease control effects. For the threshold and pre-threshold lesions, the effect of anti-VEGF therapy for zoneⅡ lesions is better than that for zone Ⅰ lesions and the single-time effective rate is high. So, it is suggested that anti-VEGF therapy should be preferred for the first treatment. The choice of repeat treatment should be considered from the final retinal structure and functional prognosis. Laser therapy is advisable for the abnormal vascular regression slower and abnormalities in the posterior pole. It can reduce the number of reexaminations and prolong the interval between re-examinations. However, the premature use of laser has an inevitable effect on peripheral vision field. Excluding the above problems, supplemental therapy can still choose anti-VEGF therapy again. Most of the children with twice anti-VEGF therapy are sufficient to control the disease. Anti-VEGF therapy should be terminated when there are signs such as plus regression, threshold or pre-threshold lesions controlled without recurrence, peripheral vascularization, etc.
Objective To explore the effect of oxygen inhalation on the retinae of newborn rats and its mechanism.Methods We mimicked the retinopathy of prematurity(ROP) by putting the newborn rats in high concentrated oxygen. One-day old rats were put into the oxygen box with the oxygen concentration of 80% for continuous 7 days; then in air condition for 7 days. The arterial blood oxygen pressure, retinal superoxide dismutase (SOD), and malondialdehyde (MDA) of the rats (1,2,4,7,8,9,11,14 days old) were examined. The diameter of retinal vessels′main branch and the coverage rate of peripheral vessels were measured in 7- and 14-day-old rats by ink perfusion. The retinal neovascularization of rats (8,9,11, 14 days old) were observed by HE staining. The rats of the same age fed in air condition were in the control group.Results The differential pressures of blood oxygen of rats (1,2,4,7 days old) in study group were significantly higher than those in the control group (P＜0.01), while the differential pressures of blood oxygen of rats (8,9,11,14 days old) in study group were lower than those in the control group (P＞0.05). The contents of SOD of the retinae in the rats ( 1,2,4,7,8 days old) were significantly lower than those in the control group(P＜0.01, P＜0.05 ), while the contents of MDA were significantly higher than those in the control group (P＜0.01,P＜0.05). The diameter of retinal vessels′main branch in 7-day rats was 75% of the control group, and the coverage rate of peripheral vessels was 22% of the control group; and was 61% and 73% respectively in 14-day-old rats. The neovascularization could be seen in 16.7% of the rats in the study group and nought in the control group.Conclusion The damage of free radical of the retina in high concentrated oxygen and hypoxia situation after oxygen supply may be one of the most important mechanism of ROP. (Chin J Ocul Fundus Dis，2003，19：269-332)
Objective To evaluate the effect of the treatment of diode laser for retinopathy of prematuriy (ROP).Methods Six-eight premature infants, with the gestation lt;32 weeks and birth weight lt;1500 g,were examined 6-7 weeks after birth. The infants suffering from threshold ROP were treated by diode laser through a binocular indirect ophthalmoscope within 48 hours after the confirmation of diagnosis, and with the follow-up of 4～6 moths. Retinal detachment was found in 1 eye 1 month after laser treatment, and scleral encircling operation was performed on the eye which was followed up for 3 months after the operation. Cycloplegic refractive examination was performed on the eyes with threshold ROP 4 months postnatally to determine the presence of refractive errors.Results Six infants (1) eyes were diagnosed as with threshold ROP. The average age of the occurrence of threshold ROP were (10±2.89) (ranging from 6 to 14 weeks) weeks postnatally. The successful rate of diode laser treatment was 91.67%. Retina was flat in one eye treated by scleral encircling operation. Refractive errors of the eye treated by scleral encircling operation was -14.5 D, and the median spherical equivalent errors in other 11 eyes was ( -2.89±-1.86) D. Conclusion The treatment of diode laser is effective for threshhold ROP. (Chin J Ocul Fundus Dis，2003，19：96-98)