首页 > 最新文献

Eye and Brain最新文献

英文 中文
Anti-VEGF therapy in the management of retinopathy of prematurity: what we learn from representative animal models of oxygen-induced retinopathy. 抗vegf治疗早产儿视网膜病变:我们从氧诱导视网膜病变的代表性动物模型中学到的东西
IF 4.4 Q1 OPHTHALMOLOGY Pub Date : 2016-05-20 eCollection Date: 2016-01-01 DOI: 10.2147/EB.S94449
Haibo Wang

Retinopathy of prematurity (ROP) remains a leading cause of childhood blindness, affecting infants born prematurely. ROP is characterized by the onset of delayed physiological retinal vascular development (PRVD) and followed by pathologic neovascularization into the vitreous instead of the retina, called intravitreal neovascularization (IVNV). Therefore, the therapeutic strategy for treating ROP is to promote PRVD and inhibit or prevent IVNV. Vascular endothelial growth factor (VEGF) plays an important role in the pathogenesis of ROP. There is a growing body of studies testing the use of anti-VEGF agents as a treatment for ROP. Intravitreal anti-VEGF treatment for ROP has potential advantages compared with laser photocoagulation, the gold standard for the treatment of severe ROP; however, intravitreal anti-VEGF treatment has been associated with reactivation of ROP and suppression of systemic VEGF that may affect body growth and organ development in preterm infants. Therefore, it is important to understand the role of VEGF in PRVD and IVNV. This review includes the current knowledge of anti-VEGF treatment for ROP from animal models of oxygen-induced retinopathy (OIR), highlighting the importance of VEGF inhibition by targeting retinal Müller cells, which inhibits IVNV and permits PRVD. The signaling events involved in mediating VEGF expression and promoting VEGF-mediated angiogenesis, including hypoxia-dependent signaling, erythropoietin/erythropoietin receptor-, oxidative stress-, beta-adrenergic receptor-, integrin-, Notch/Delta-like ligand 4- and exon guidance molecules-mediated signaling pathways, are also discussed.

早产儿视网膜病变(ROP)仍然是儿童失明的主要原因,影响早产儿。ROP的特点是生理性视网膜血管发育(PRVD)延迟,随后病理性新生血管进入玻璃体而不是视网膜,称为玻璃体内新生血管(IVNV)。因此,治疗ROP的治疗策略是促进PRVD,抑制或预防IVNV。血管内皮生长因子(VEGF)在ROP的发病机制中起重要作用。越来越多的研究测试使用抗vegf药物治疗ROP。玻璃体内抗vegf治疗ROP与治疗重度ROP的金标准激光光凝相比具有潜在优势;然而,玻璃体内抗VEGF治疗与ROP的再激活和全身VEGF的抑制有关,这可能影响早产儿的身体生长和器官发育。因此,了解VEGF在PRVD和IVNV中的作用非常重要。本文综述了氧诱导视网膜病变(OIR)动物模型中抗VEGF治疗ROP的现有知识,强调了通过靶向视网膜膜层细胞抑制VEGF的重要性,这可以抑制IVNV并允许PRVD。还讨论了介导VEGF表达和促进VEGF介导的血管生成的信号通路,包括缺氧依赖性信号通路、促红细胞生成素/促红细胞生成素受体-、氧化应激-、β -肾上腺素能受体-、整合素-、Notch/ δ样配体4-和外显子引导分子介导的信号通路。
{"title":"Anti-VEGF therapy in the management of retinopathy of prematurity: what we learn from representative animal models of oxygen-induced retinopathy.","authors":"Haibo Wang","doi":"10.2147/EB.S94449","DOIUrl":"https://doi.org/10.2147/EB.S94449","url":null,"abstract":"<p><p>Retinopathy of prematurity (ROP) remains a leading cause of childhood blindness, affecting infants born prematurely. ROP is characterized by the onset of delayed physiological retinal vascular development (PRVD) and followed by pathologic neovascularization into the vitreous instead of the retina, called intravitreal neovascularization (IVNV). Therefore, the therapeutic strategy for treating ROP is to promote PRVD and inhibit or prevent IVNV. Vascular endothelial growth factor (VEGF) plays an important role in the pathogenesis of ROP. There is a growing body of studies testing the use of anti-VEGF agents as a treatment for ROP. Intravitreal anti-VEGF treatment for ROP has potential advantages compared with laser photocoagulation, the gold standard for the treatment of severe ROP; however, intravitreal anti-VEGF treatment has been associated with reactivation of ROP and suppression of systemic VEGF that may affect body growth and organ development in preterm infants. Therefore, it is important to understand the role of VEGF in PRVD and IVNV. This review includes the current knowledge of anti-VEGF treatment for ROP from animal models of oxygen-induced retinopathy (OIR), highlighting the importance of VEGF inhibition by targeting retinal Müller cells, which inhibits IVNV and permits PRVD. The signaling events involved in mediating VEGF expression and promoting VEGF-mediated angiogenesis, including hypoxia-dependent signaling, erythropoietin/erythropoietin receptor-, oxidative stress-, beta-adrenergic receptor-, integrin-, Notch/Delta-like ligand 4- and exon guidance molecules-mediated signaling pathways, are also discussed.</p>","PeriodicalId":51844,"journal":{"name":"Eye and Brain","volume":"8 ","pages":"81-90"},"PeriodicalIF":4.4,"publicationDate":"2016-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/EB.S94449","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35024225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 21
Retinal, visual, and refractive development in retinopathy of prematurity. 早产儿视网膜病变的视网膜、视觉和屈光发育。
IF 4.4 Q1 OPHTHALMOLOGY Pub Date : 2016-05-20 eCollection Date: 2016-01-01 DOI: 10.2147/EB.S95021
Anne Moskowitz, Ronald M Hansen, Anne B Fulton

The pivotal role of the neurosensory retina in retinopathy of prematurity (ROP) disease processes has been amply demonstrated in rat models. We have hypothesized that analogous cellular processes are operative in human ROP and have evaluated these presumptions in a series on non-invasive investigations of the photoreceptor and post-receptor peripheral and central retina in infants and children. Key results are slowed kinetics of phototransduction and deficits in photoreceptor sensitivity that persist years after ROP has completely resolved based on clinical criteria. On the other hand, deficits in post-receptor sensitivity are present in infancy regardless of the severity of the ROP but are not present in older children if the ROP was so mild that it never required treatment and resolved without a clinical trace. Accompanying the persistent deficits in photoreceptor sensitivity, there is increased receptive field size and thickening of the post-receptor retinal laminae in the peripheral retina of ROP subjects. In the late maturing central retina, which mediates visual acuity, attenuation of multifocal electroretinogram activity in the post-receptor retina led us to the discovery of a shallow foveal pit and significant thickening of the post-receptor retinal laminae in the macular region; this is most likely due to failure of the normal centrifugal movement of the post-receptor cells during foveal development. As for refractive development, myopia, at times high, is more common in ROP subjects than in control subjects, in accord with refractive findings in other populations of former preterms. This information about the neurosensory retina enhances understanding of vision in patients with a history of ROP, and taken as a whole, raises the possibility that the neurosensory retina is a target for therapeutic intervention.

神经感觉视网膜在早产儿视网膜病变(ROP)疾病过程中的关键作用已在大鼠模型中得到充分证明。我们推测人类早产儿视网膜病变也有类似的细胞过程,并通过对婴儿和儿童的感光器和后感光器外周和中央视网膜进行一系列非侵入性研究,对这些推测进行了评估。研究的主要结果是,根据临床标准,光传导动力学减慢和感光器敏感性缺损在视网膜病变完全缓解多年后仍然存在。另一方面,无论视网膜病变的严重程度如何,婴儿期都会出现感光受体后敏感性缺损,但如果视网膜病变的程度很轻,无需治疗,而且在没有临床症状的情况下就会消失,那么年龄较大的儿童就不会出现这种缺损。伴随着感光器灵敏度的持续缺陷,ROP 受试者周边视网膜的感受野增大,感受器后视网膜板层增厚。在晚期成熟的中央视网膜中,受体后视网膜的多灶视网膜电图活动衰减,导致我们发现眼窝凹陷较浅,黄斑区的受体后视网膜板层明显增厚;这很可能是由于受体后细胞在眼窝发育过程中无法正常离心运动所致。在屈光发育方面,与对照组相比,ROP 患者更常见近视,有时甚至是高度近视,这与其他早产儿人群的屈光结果一致。这些关于神经感觉视网膜的信息加深了人们对有早产儿视网膜病史的患者视力的了解,从整体上看,神经感觉视网膜有可能成为治疗干预的目标。
{"title":"Retinal, visual, and refractive development in retinopathy of prematurity.","authors":"Anne Moskowitz, Ronald M Hansen, Anne B Fulton","doi":"10.2147/EB.S95021","DOIUrl":"10.2147/EB.S95021","url":null,"abstract":"<p><p>The pivotal role of the neurosensory retina in retinopathy of prematurity (ROP) disease processes has been amply demonstrated in rat models. We have hypothesized that analogous cellular processes are operative in human ROP and have evaluated these presumptions in a series on non-invasive investigations of the photoreceptor and post-receptor peripheral and central retina in infants and children. Key results are slowed kinetics of phototransduction and deficits in photoreceptor sensitivity that persist years after ROP has completely resolved based on clinical criteria. On the other hand, deficits in post-receptor sensitivity are present in infancy regardless of the severity of the ROP but are not present in older children if the ROP was so mild that it never required treatment and resolved without a clinical trace. Accompanying the persistent deficits in photoreceptor sensitivity, there is increased receptive field size and thickening of the post-receptor retinal laminae in the peripheral retina of ROP subjects. In the late maturing central retina, which mediates visual acuity, attenuation of multifocal electroretinogram activity in the post-receptor retina led us to the discovery of a shallow foveal pit and significant thickening of the post-receptor retinal laminae in the macular region; this is most likely due to failure of the normal centrifugal movement of the post-receptor cells during foveal development. As for refractive development, myopia, at times high, is more common in ROP subjects than in control subjects, in accord with refractive findings in other populations of former preterms. This information about the neurosensory retina enhances understanding of vision in patients with a history of ROP, and taken as a whole, raises the possibility that the neurosensory retina is a target for therapeutic intervention.</p>","PeriodicalId":51844,"journal":{"name":"Eye and Brain","volume":"8 ","pages":"103-111"},"PeriodicalIF":4.4,"publicationDate":"2016-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/53/8c/eb-8-103.PMC5398748.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35024227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of improved neonatal care on the profile of retinopathy of prematurity in rural neonatal centers in India over a 4-year period. 改善新生儿护理对印度农村新生儿中心4年早产儿视网膜病变概况的影响。
IF 4.4 Q1 OPHTHALMOLOGY Pub Date : 2016-05-20 eCollection Date: 2016-01-01 DOI: 10.2147/EB.S98715
Anand Vinekar, Chaitra Jayadev, Siddesh Kumar, Shwetha Mangalesh, Mangat Ram Dogra, Noel J Bauer, Bhujang Shetty

Purpose: To report the reduction in the incidence and severity of retinopathy of prematurity (ROP) in rural India over a 4-year period following the introduction of improved neonatal care practices.

Methods: The Karnataka Internet Diagnosis of Retinopathy of Prematurity program (KIDROP), is a tele-medicine network that screens for ROP in different zones of Karnataka state in rural India. North Karnataka is the most underdeveloped and remote zone of this program and did not have any ROP screening programs before the intervention of the KIDROP in 2011. Six government and eleven private neonatal centers in this zone were screened weekly. Specific neonatal guidelines for ROP were developed and introduced in these centers. They included awareness about risk factors, oxygen regulation protocols, use of pulse oxymetry, monitoring postnatal weight gain, nutritional best practices, and management of sepsis. The incidence and severity of ROP were compared before the guidelines were introduced (Jan 2011 to Dec 2012) and after the guidelines were introduced (July 2013 to June 2015).

Results: During this 4-year period, 4,167 infants were screened over 11,390 imaging sessions. The number of enrolled infants increased from 1,825 to 2,342 between the two periods (P<0.001). The overall incidence of any stage ROP reduced significantly from 26.8% to 22.4% (P<0.001). The incidence of treatment-requiring ROP reduced from 20.7% to 16% (P=0.06), and of the treated disease, aggressive posterior ROP reduced from 20.8% to 13.1% (P=0.23) following introduction of the guidelines.

Discussion: Rural neonatal centers in middle-income countries have a large, unscreened burden of ROP. Improving neonatal care in these centers can positively impact the incidence and severity of ROP even in a relatively short period. A combined approach of a robust ROP screening program and improved neonatal care practices is required to address the challenge.

目的:报告印度农村早产儿视网膜病变(ROP)的发病率和严重程度在引进改进的新生儿护理实践后的4年期间的降低。方法:卡纳塔克邦互联网早产儿视网膜病变诊断项目(KIDROP)是一个远程医疗网络,在印度农村卡纳塔克邦的不同地区筛查视网膜病变。北卡纳塔克邦是该项目最不发达和偏远的地区,在2011年KIDROP干预之前没有任何ROP筛查项目。该地区的6个政府和11个私人新生儿中心每周进行筛查。这些中心制定并介绍了新生儿ROP的具体指南。其中包括对危险因素的认识、氧气调节方案、脉搏血氧仪的使用、产后体重增加的监测、营养最佳做法和败血症的管理。比较指南实施前(2011年1月至2012年12月)和实施后(2013年7月至2015年6月)ROP的发生率和严重程度。结果:在这4年期间,4167名婴儿接受了11,390次影像学检查。在这两个时期,入组婴儿的数量从1825名增加到2342名(PPP=0.06),在接受治疗的疾病中,引入指南后,侵袭性后路ROP从20.8%减少到13.1% (P=0.23)。讨论:中等收入国家的农村新生儿中心存在大量未经筛查的ROP负担。在这些中心改善新生儿护理可以积极影响ROP的发生率和严重程度,即使在相对较短的时间内。需要一个强有力的ROP筛查项目和改进的新生儿护理实践相结合的方法来应对这一挑战。
{"title":"Impact of improved neonatal care on the profile of retinopathy of prematurity in rural neonatal centers in India over a 4-year period.","authors":"Anand Vinekar,&nbsp;Chaitra Jayadev,&nbsp;Siddesh Kumar,&nbsp;Shwetha Mangalesh,&nbsp;Mangat Ram Dogra,&nbsp;Noel J Bauer,&nbsp;Bhujang Shetty","doi":"10.2147/EB.S98715","DOIUrl":"https://doi.org/10.2147/EB.S98715","url":null,"abstract":"<p><strong>Purpose: </strong>To report the reduction in the incidence and severity of retinopathy of prematurity (ROP) in rural India over a 4-year period following the introduction of improved neonatal care practices.</p><p><strong>Methods: </strong>The Karnataka Internet Diagnosis of Retinopathy of Prematurity program (KIDROP), is a tele-medicine network that screens for ROP in different zones of Karnataka state in rural India. North Karnataka is the most underdeveloped and remote zone of this program and did not have any ROP screening programs before the intervention of the KIDROP in 2011. Six government and eleven private neonatal centers in this zone were screened weekly. Specific neonatal guidelines for ROP were developed and introduced in these centers. They included awareness about risk factors, oxygen regulation protocols, use of pulse oxymetry, monitoring postnatal weight gain, nutritional best practices, and management of sepsis. The incidence and severity of ROP were compared before the guidelines were introduced (Jan 2011 to Dec 2012) and after the guidelines were introduced (July 2013 to June 2015).</p><p><strong>Results: </strong>During this 4-year period, 4,167 infants were screened over 11,390 imaging sessions. The number of enrolled infants increased from 1,825 to 2,342 between the two periods (<i>P</i><0.001). The overall incidence of any stage ROP reduced significantly from 26.8% to 22.4% (<i>P</i><0.001). The incidence of treatment-requiring ROP reduced from 20.7% to 16% (<i>P</i>=0.06), and of the treated disease, aggressive posterior ROP reduced from 20.8% to 13.1% (<i>P</i>=0.23) following introduction of the guidelines.</p><p><strong>Discussion: </strong>Rural neonatal centers in middle-income countries have a large, unscreened burden of ROP. Improving neonatal care in these centers can positively impact the incidence and severity of ROP even in a relatively short period. A combined approach of a robust ROP screening program and improved neonatal care practices is required to address the challenge.</p>","PeriodicalId":51844,"journal":{"name":"Eye and Brain","volume":"8 ","pages":"45-53"},"PeriodicalIF":4.4,"publicationDate":"2016-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/EB.S98715","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35024223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 21
Targeting VEGF in canine oxygen-induced retinopathy - a model for human retinopathy of prematurity. 靶向VEGF治疗犬氧诱导视网膜病变-人早产儿视网膜病变模型。
IF 4.4 Q1 OPHTHALMOLOGY Pub Date : 2016-05-20 eCollection Date: 2016-01-01 DOI: 10.2147/EB.S94443
D Scott McLeod, Gerard A Lutty

Development of the dog superficial retinal vasculature is similar to the mechanism of human retinal vasculature development; they both develop by vasculogenesis, differentiation, and assembly of vascular precursors called angioblasts. Canine oxygen-induced retinopathy (OIR) was first developed by Arnall Patz in an effort to experimentally determine the effects of hyperoxia on the development of the retinal vasculature. The canine OIR model has many characteristics in common with human retinopathy of prematurity. Exposure of 1-day-old dogs to hyperoxia for 4 days causes a vaso-obliteration throughout the retina. Vasoproliferation, after the animals have returned to room air, is robust. The initial small preretinal neovascular formations anastomose to form large preretinal membranes that eventually cause tractional retinal folds. The end-stage pathology of the canine model is similar to stage IV human retinopathy of prematurity. Therefore, canine OIR is an excellent forum to evaluate the response to drugs targeting VEGF and its receptors. Evaluation of an antibody to VEGF-R2 and the VEGF-Trap demonstrated that doses should be titered down so that preretinal neovascularization is inhibited but retinal revascularization is able to proceed, vascularizing peripheral retina and preventing it from being a source of VEGF.

犬视网膜浅表血管的发育机制与人类视网膜血管的发育机制相似;它们都是通过血管发生、分化和血管前体(称为成血管细胞)的组装而形成的。犬氧诱导视网膜病变(OIR)是由Arnall Patz首先提出的,目的是通过实验确定高氧对视网膜血管系统发育的影响。犬类视网膜病变与人类早产儿视网膜病变有许多共同的特点。1天大的狗暴露于高氧环境4天会导致整个视网膜血管闭塞。在动物回到室内空气后,血管增生非常强劲。最初的小视网膜前新生血管相互吻合形成大的视网膜前膜,最终引起牵拉性视网膜褶皱。犬模型的终末期病理与人类早产儿视网膜病变IV期相似。因此,犬OIR是评估针对VEGF及其受体的药物反应的一个很好的论坛。对VEGF- r2抗体和VEGF- trap的评估表明,剂量应该降低,以抑制视网膜前的新血管形成,但视网膜的血管重建能够进行,使周围视网膜血管化,并防止其成为VEGF的来源。
{"title":"Targeting VEGF in canine oxygen-induced retinopathy - a model for human retinopathy of prematurity.","authors":"D Scott McLeod,&nbsp;Gerard A Lutty","doi":"10.2147/EB.S94443","DOIUrl":"https://doi.org/10.2147/EB.S94443","url":null,"abstract":"<p><p>Development of the dog superficial retinal vasculature is similar to the mechanism of human retinal vasculature development; they both develop by vasculogenesis, differentiation, and assembly of vascular precursors called angioblasts. Canine oxygen-induced retinopathy (OIR) was first developed by Arnall Patz in an effort to experimentally determine the effects of hyperoxia on the development of the retinal vasculature. The canine OIR model has many characteristics in common with human retinopathy of prematurity. Exposure of 1-day-old dogs to hyperoxia for 4 days causes a vaso-obliteration throughout the retina. Vasoproliferation, after the animals have returned to room air, is robust. The initial small preretinal neovascular formations anastomose to form large preretinal membranes that eventually cause tractional retinal folds. The end-stage pathology of the canine model is similar to stage IV human retinopathy of prematurity. Therefore, canine OIR is an excellent forum to evaluate the response to drugs targeting VEGF and its receptors. Evaluation of an antibody to VEGF-R2 and the VEGF-Trap demonstrated that doses should be titered down so that preretinal neovascularization is inhibited but retinal revascularization is able to proceed, vascularizing peripheral retina and preventing it from being a source of VEGF.</p>","PeriodicalId":51844,"journal":{"name":"Eye and Brain","volume":"8 ","pages":"55-65"},"PeriodicalIF":4.4,"publicationDate":"2016-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/EB.S94443","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35024224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 9
Retinopathy of prematurity: the need for prevention. 早产儿视网膜病变:需要预防。
IF 4.4 Q1 OPHTHALMOLOGY Pub Date : 2016-05-20 eCollection Date: 2016-01-01 DOI: 10.2147/EB.S99038
Raffael Liegl, Ann Hellström, Lois Eh Smith

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.

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。
{"title":"Retinopathy of prematurity: the need for prevention.","authors":"Raffael Liegl,&nbsp;Ann Hellström,&nbsp;Lois Eh Smith","doi":"10.2147/EB.S99038","DOIUrl":"https://doi.org/10.2147/EB.S99038","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":51844,"journal":{"name":"Eye and Brain","volume":"8 ","pages":"91-102"},"PeriodicalIF":4.4,"publicationDate":"2016-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/EB.S99038","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35024226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 36
Current screening and treatments in retinopathy of prematurity in the US. 美国早产儿视网膜病变的筛查和治疗现状
IF 4.4 Q1 OPHTHALMOLOGY Pub Date : 2016-05-20 eCollection Date: 2016-01-01 DOI: 10.2147/EB.S94439
Ana M Suelves, Julia P Shulman

Retinopathy of prematurity (ROP) is a complex disease characterized by an aberrant developmental retinal angiogenesis in preterm infants and can carry significant visual morbidity, including retinal detachment and blindness. Though large scale, randomized clinical trials have improved our understanding of the pathophysiology and progression of the disease, the management of ROP remains a challenge for ophthalmologists. This review addresses the up-to-date screening approach, diagnosis, and treatment guidelines for ROP in the US.

早产儿视网膜病变(ROP)是一种复杂的疾病,其特征是早产儿视网膜血管生成异常发育,可导致严重的视力疾病,包括视网膜脱离和失明。虽然大规模的随机临床试验提高了我们对该病病理生理和进展的理解,但ROP的治疗仍然是眼科医生面临的一个挑战。本文综述了美国ROP的最新筛查方法、诊断和治疗指南。
{"title":"Current screening and treatments in retinopathy of prematurity in the US.","authors":"Ana M Suelves,&nbsp;Julia P Shulman","doi":"10.2147/EB.S94439","DOIUrl":"https://doi.org/10.2147/EB.S94439","url":null,"abstract":"<p><p>Retinopathy of prematurity (ROP) is a complex disease characterized by an aberrant developmental retinal angiogenesis in preterm infants and can carry significant visual morbidity, including retinal detachment and blindness. Though large scale, randomized clinical trials have improved our understanding of the pathophysiology and progression of the disease, the management of ROP remains a challenge for ophthalmologists. This review addresses the up-to-date screening approach, diagnosis, and treatment guidelines for ROP in the US.</p>","PeriodicalId":51844,"journal":{"name":"Eye and Brain","volume":"8 ","pages":"37-43"},"PeriodicalIF":4.4,"publicationDate":"2016-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/EB.S94439","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35024222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 16
Retinopathy of prematurity blindness worldwide: phenotypes in the third epidemic. 世界范围内的早产儿失明视网膜病变:第三次流行的表型
IF 4.4 Q1 OPHTHALMOLOGY Pub Date : 2016-05-19 eCollection Date: 2016-01-01 DOI: 10.2147/EB.S94436
Graham E Quinn

Blindness due to retinopathy of prematurity (ROP) is an increasing problem worldwide as improved levels of neonatal care are provided in countries with developing neonatal intensive care units. The occurrence of ROP blindness varies dramatically with the socioeconomic development of a country. In regions with high levels of neonatal care and adequate resources, ROP blindness is largely restricted to premature infants with very low birth weight and low gestational age while in middle- and low-income countries with regional variation in technology and capacity, limited health resources may well limit the care of the premature newborn.

由于早产儿视网膜病变(ROP)引起的失明在世界范围内是一个日益严重的问题,因为在发展中的新生儿重症监护病房的国家,新生儿护理水平得到了提高。ROP盲症的发生随国家社会经济发展程度的不同而有很大差异。在新生儿护理水平高且资源充足的地区,ROP失明主要局限于出生体重极低和胎龄低的早产儿,而在技术和能力存在区域差异的中低收入国家,有限的卫生资源很可能限制对早产儿的护理。
{"title":"Retinopathy of prematurity blindness worldwide: phenotypes in the third epidemic.","authors":"Graham E Quinn","doi":"10.2147/EB.S94436","DOIUrl":"https://doi.org/10.2147/EB.S94436","url":null,"abstract":"<p><p>Blindness due to retinopathy of prematurity (ROP) is an increasing problem worldwide as improved levels of neonatal care are provided in countries with developing neonatal intensive care units. The occurrence of ROP blindness varies dramatically with the socioeconomic development of a country. In regions with high levels of neonatal care and adequate resources, ROP blindness is largely restricted to premature infants with very low birth weight and low gestational age while in middle- and low-income countries with regional variation in technology and capacity, limited health resources may well limit the care of the premature newborn.</p>","PeriodicalId":51844,"journal":{"name":"Eye and Brain","volume":"8 ","pages":"31-36"},"PeriodicalIF":4.4,"publicationDate":"2016-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/EB.S94436","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35023717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 81
Advances in diagnosis, clinical care, research, and treatment in retinopathy of prematurity 早产儿视网膜病变的诊断、临床护理、研究和治疗进展
IF 4.4 Q1 OPHTHALMOLOGY Pub Date : 2016-05-19 DOI: 10.2147/EB.S105319
Drs Patricia D’Amore, K. Connor, Drs Cynthia Toth
The appearance of retinopathy of prematurity (ROP) has changed throughout the world and since the first description of “retrolental fibroplasia” in 1942. However, despite advances in neonatal care and the abilities to improve the survival of ever younger and smaller premature infants, ROP remains a leading cause of childhood blindness worldwide. We know that ROP is complex in that it is influenced by genetic predisposition, epigenetic regulation, and environmental risks. It is strongly associated with extreme degrees of prematurity, and the “phenotype” of ROP depends on resources available to support premature infants with adequate nutrition and regulation of oxygen, as examples. New studies also suggest that what is seen in the preterm infant retina may portend later neurodevelopmental outcomes. Therefore, we believe this is a needed time to revisit ROP and provide a thematic issue focused on ROP from several perspectives.
自1942年首次描述“视网膜后纤维增生”以来,早产儿视网膜病变(ROP)的外观在世界范围内发生了变化。然而,尽管在新生儿护理方面取得了进步,并且有能力提高更小和更小的早产儿的存活率,ROP仍然是世界范围内儿童失明的主要原因。我们知道ROP是复杂的,因为它受到遗传易感性、表观遗传调控和环境风险的影响。它与极端程度的早产密切相关,例如,ROP的“表型”取决于为早产儿提供充足营养和氧气调节的可用资源。新的研究还表明,在早产儿视网膜上所看到的可能预示着后来的神经发育结果。因此,我们认为现在是重新审视机械钻速的必要时机,并从几个角度提供一个专注于机械钻速的专题问题。
{"title":"Advances in diagnosis, clinical care, research, and treatment in retinopathy of prematurity","authors":"Drs Patricia D’Amore, K. Connor, Drs Cynthia Toth","doi":"10.2147/EB.S105319","DOIUrl":"https://doi.org/10.2147/EB.S105319","url":null,"abstract":"The appearance of retinopathy of prematurity (ROP) has changed throughout the world and since the first description of “retrolental fibroplasia” in 1942. However, despite advances in neonatal care and the abilities to improve the survival of ever younger and smaller premature infants, ROP remains a leading cause of childhood blindness worldwide. We know that ROP is complex in that it is influenced by genetic predisposition, epigenetic regulation, and environmental risks. It is strongly associated with extreme degrees of prematurity, and the “phenotype” of ROP depends on resources available to support premature infants with adequate nutrition and regulation of oxygen, as examples. New studies also suggest that what is seen in the preterm infant retina may portend later neurodevelopmental outcomes. Therefore, we believe this is a needed time to revisit ROP and provide a thematic issue focused on ROP from several perspectives.","PeriodicalId":51844,"journal":{"name":"Eye and Brain","volume":"8 1","pages":"27 - 29"},"PeriodicalIF":4.4,"publicationDate":"2016-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/EB.S105319","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68359772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Progress in the clinical development and utilization of vision prostheses: an update. 视觉假体的临床开发与应用进展。
IF 4.4 Q1 OPHTHALMOLOGY Pub Date : 2016-05-11 eCollection Date: 2016-01-01 DOI: 10.2147/EB.S70822
Alice Brandli, Chi D Luu, Robyn H Guymer, Lauren N Ayton

Vision prostheses, or "bionic eyes", are implantable medical bionic devices with the potential to restore rudimentary sight to people with profound vision loss or blindness. In the past two decades, this field has rapidly progressed, and there are now two commercially available retinal prostheses in the US and Europe, and a number of next-generation devices in development. This review provides an update on the development of these devices and a discussion on the future directions for the field.

视觉假体,或“仿生眼”,是一种植入式医学仿生装置,有可能恢复严重视力丧失或失明的人的基本视力。在过去的二十年里,这一领域发展迅速,现在在美国和欧洲有两种商业化的视网膜假体,还有一些下一代设备正在开发中。本文综述了这些设备的最新发展,并讨论了该领域的未来发展方向。
{"title":"Progress in the clinical development and utilization of vision prostheses: an update.","authors":"Alice Brandli,&nbsp;Chi D Luu,&nbsp;Robyn H Guymer,&nbsp;Lauren N Ayton","doi":"10.2147/EB.S70822","DOIUrl":"https://doi.org/10.2147/EB.S70822","url":null,"abstract":"<p><p>Vision prostheses, or \"bionic eyes\", are implantable medical bionic devices with the potential to restore rudimentary sight to people with profound vision loss or blindness. In the past two decades, this field has rapidly progressed, and there are now two commercially available retinal prostheses in the US and Europe, and a number of next-generation devices in development. This review provides an update on the development of these devices and a discussion on the future directions for the field.</p>","PeriodicalId":51844,"journal":{"name":"Eye and Brain","volume":"8 ","pages":"15-25"},"PeriodicalIF":4.4,"publicationDate":"2016-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/EB.S70822","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35023716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 18
Clinical biomarkers and molecular basis for optimized treatment of diabetic retinopathy: current status and future prospects. 糖尿病视网膜病变优化治疗的临床生物标志物及分子基础:现状与展望
IF 4.4 Q1 OPHTHALMOLOGY Pub Date : 2016-02-19 eCollection Date: 2016-01-01 DOI: 10.2147/EB.S69185
Rohit Saxena, Digvijay Singh, Ravi Saklani, Suresh Kumar Gupta

Diabetic retinopathy is a highly specific microvascular complication of diabetes and a leading cause of blindness worldwide. It is triggered by hyperglycemia which causes increased oxidative stress leading to an adaptive inflammatory assault to the neuroretinal tissue and microvasculature. Prolonged hyperglycemia causes increased polyol pathway flux, increased formation of advanced glycation end-products, abnormal activation of signaling cascades such as activation of protein kinase C (PKC) pathway, increased hexosamine pathway flux, and peripheral nerve damage. All these changes lead to increased oxidative stress and inflammatory assault to the retina resulting in structural and functional changes. In addition, neuroretinal alterations affect diabetes progression. The most effective way to manage diabetic retinopathy is by primary prevention such as hyperglycemia control. While the current mainstay for the management of severe and proliferative diabetic retinopathy is laser photocoagulation, its role is diminishing with the development of newer drugs including corticosteroids, antioxidants, and antiangiogenic and anti-VEGF agents which work as an adjunct to laser therapy or independently. The current pharmacotherapy of diabetic retinopathy is incomplete as a sole treatment option in view of limited efficacy and short-term effect. There is a definite clinical need to develop new pharmacological therapies for diabetic retinopathy, particularly ones which would be effective through the oral route and help recover lost vision. The increasing understanding of the mechanisms of diabetic retinopathy and its biomarkers is likely to help generate better and more effective medications.

糖尿病视网膜病变是一种高度特异性的糖尿病微血管并发症,也是全世界失明的主要原因。它是由高血糖引发的,高血糖引起氧化应激增加,导致对神经视网膜组织和微血管的适应性炎症攻击。长期高血糖导致多元醇途径通量增加,晚期糖基化终产物形成增加,信号级联的异常激活,如蛋白激酶C (PKC)途径的激活,己糖胺途径通量增加和周围神经损伤。所有这些变化导致视网膜氧化应激增加和炎症攻击,导致结构和功能改变。此外,神经视网膜的改变影响糖尿病的进展。治疗糖尿病视网膜病变最有效的方法是一级预防,如控制高血糖。虽然目前治疗严重和增殖性糖尿病视网膜病变的主要方法是激光光凝,但随着新药物的发展,其作用正在减弱,包括皮质类固醇、抗氧化剂、抗血管生成和抗vegf药物,这些药物可作为激光治疗的辅助或独立使用。目前糖尿病视网膜病变的药物治疗是不完整的唯一治疗选择,鉴于有限的疗效和短期效果。有明确的临床需要开发新的药物治疗糖尿病视网膜病变,特别是通过口服途径有效,帮助恢复视力。对糖尿病视网膜病变及其生物标志物机制的日益了解可能有助于产生更好和更有效的药物。
{"title":"Clinical biomarkers and molecular basis for optimized treatment of diabetic retinopathy: current status and future prospects.","authors":"Rohit Saxena,&nbsp;Digvijay Singh,&nbsp;Ravi Saklani,&nbsp;Suresh Kumar Gupta","doi":"10.2147/EB.S69185","DOIUrl":"https://doi.org/10.2147/EB.S69185","url":null,"abstract":"<p><p>Diabetic retinopathy is a highly specific microvascular complication of diabetes and a leading cause of blindness worldwide. It is triggered by hyperglycemia which causes increased oxidative stress leading to an adaptive inflammatory assault to the neuroretinal tissue and microvasculature. Prolonged hyperglycemia causes increased polyol pathway flux, increased formation of advanced glycation end-products, abnormal activation of signaling cascades such as activation of protein kinase C (PKC) pathway, increased hexosamine pathway flux, and peripheral nerve damage. All these changes lead to increased oxidative stress and inflammatory assault to the retina resulting in structural and functional changes. In addition, neuroretinal alterations affect diabetes progression. The most effective way to manage diabetic retinopathy is by primary prevention such as hyperglycemia control. While the current mainstay for the management of severe and proliferative diabetic retinopathy is laser photocoagulation, its role is diminishing with the development of newer drugs including corticosteroids, antioxidants, and antiangiogenic and anti-VEGF agents which work as an adjunct to laser therapy or independently. The current pharmacotherapy of diabetic retinopathy is incomplete as a sole treatment option in view of limited efficacy and short-term effect. There is a definite clinical need to develop new pharmacological therapies for diabetic retinopathy, particularly ones which would be effective through the oral route and help recover lost vision. The increasing understanding of the mechanisms of diabetic retinopathy and its biomarkers is likely to help generate better and more effective medications.</p>","PeriodicalId":51844,"journal":{"name":"Eye and Brain","volume":"8 ","pages":"1-13"},"PeriodicalIF":4.4,"publicationDate":"2016-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/EB.S69185","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35023718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 13
期刊
Eye and Brain
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1