Non-invasive approach predicts retinopathy of prematurity: Researchers

CHICAGO: The most prevalent cause of avoidable irreversible blindness in infants in the United States, retinopathy of prematurity (ROP), has been the focus of an intensive study at Ann & Robert H. Lurie infants's Hospital of Chicago.

The improper growth of tiny blood vessels on the retina causes ROP. Isabelle De Plaen, MD, and colleagues discovered that examining the capillaries in preemies' nailbeds within the first month of life using a non-invasive procedure known as nailbed capillaroscopy can detect newborns at high risk for developing ROP. This screening might reduce the requirement to do eye tests on all preterm children around a month later.

The research was published in the Journal of Paediatrics.

"Abnormal systemic vascular development starts much earlier than we thought. By measuring the nailbed capillary density soon after birth we can identify premature infants at higher risk for developing ROP long before it is detectable by an eye exam," said Dr. De Plaen, senior author and neonatologist at Lurie Children's, as well as Professor of Pediatrics at Northwestern University Feinberg School of Medicine, adding, "Earlier identification of these infants reduces the need to subject all premature babies to highly invasive eye exams. Our findings might also lead to the development of earlier preventive or therapeutic interventions for ROP and other complications of prematurity associated with maldevelopment of microvasculature." ROP occurs in about 1/500-1/1,000 premature infants.

It affects 33 per cent -60 per cent of babies with very low birth weight (less than 1,500g).

In the cohort of 32 premature neonates they studied, Dr. De Plaen and colleagues found that nailbed capillary density was higher in babies who later developed ROP.

Microvascular density in the first month of life also correlated with the severity of ROP.

"The differences we found in microvascular density were most striking near birth, suggesting that perturbed microvascular development may begin in utero during the perinatal period, impacting organ microvascular development," said Dr. De Plaen.

"We speculate that nailfold microvascular density quantification has the potential to help further characterize the link between the uterine environment, placental health and outcomes of preterm birth, so that we can improve those outcomes." Research at Ann & Robert H.

Lurie Children's Hospital of Chicago is conducted through Stanley Manne Children's Research Institute.

The Manne Research Institute is focused on improving child health, transforming pediatric medicine and ensuring healthier futures through the relentless pursuit of knowledge.

Lurie Children's is a nonprofit organization committed to providing access to exceptional care for every child. It is ranked as one of the nation's top children's hospitals by U.S. News & World Report. Lurie Children's is the pediatric training ground for Northwestern University Feinberg School of Medicine.