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Retinopathy of prematurity: saving babies’ sight

This research was completed on 15 December 2013

Published on 29 October 2010

Retinopathy of prematurity (ROP) is a major cause of vision loss in young children.1,2 Babies who are born very prematurely, whose birth weight is very low, are most at risk. Existing treatment normally saves babies’ central vision, but this benefit comes at the expense of permanent damage to babies’ peripheral and night vision. Researchers are searching for a better way to save babies’ sight, by exploring a key step in the early stages of the disease process.

Contents

What's the problem and who does it affect?

A threat to babies’ sight

Retinopathy of prematurity – or ROP – is a major cause of vision loss and blindness in young children.1 Babies who are born very prematurely, whose birth weight is very low, are most at risk.

Premature babies who need extra oxygen, to save their lives, are at an even higher risk if oxygen levels are not tightly controlled. Unfortunately, such tight control is not possible in many countries, because the resources needed are too expensive.

ROP often resolves spontaneously, leaving a baby’s vision unaffected. However, about one in ten babies with ROP develops severe disease, which threatens their sight.1,3 If this is detected early enough, laser treatment can save the most important part of a baby’s vision – the sharp, central vision we need to look straight ahead, when reading or driving, for example.

However, benefits come at a price. Treatment often has the side effect of damaging babies’ peripheral and night vision. What’s more, it doesn’t always work, meaning some babies still go blind.

Worryingly, the incidence of ROP seems to be increasing, because improvements in neonatal care are giving very premature babies a better chance of surviving.3 New treatments are urgently needed.

What is the project trying to achieve?

Protecting vulnerable young eyes

The researchers are looking for possible ways to stop the development of ROP, and protect babies’ vision, by studying the earliest stages of the disease process.

Evidence suggests ROP develops in two stages:

  • Stage 1. Blood vessels that supply the eye’s light-sensitive retina stop growing properly, meaning the retina does not get enough oxygen and nutrients.
  • Stage 2. New vessels grow, in an attempt to rescue the retina, but they are abnormal and actually damage the eye, causing vision loss.

Laser treatment tackles stage 2 of the disease process. It works by stopping abnormal blood vessels from growing. However, by this stage the disease can already be quite severe.

In this project, the researchers are looking for possible new treatments that work at stage 1 of the disease process.

Evidence suggests certain naturally occurring substances, called cofactors, encourage normal growth of the delicate blood vessels that supply the retina, as long as they are present in high enough levels. In contrast, low levels of these cofactors seem to be linked to the destruction of blood vessels.

The researchers are investigating this theory in detail, and studying whether certain cofactors show promise as a possible treatment for ROP.

What are the researchers' credentials?

Project LeaderDr D McDonald PhD
Project team
  • Dr Tom Gardiner PhD
LocationCentre for Vision and Vascular Science and Centre for Biomedical Science Education, Queen's University Belfast
Other locations
  • Centre for Biomedical Sciences Education, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast.
Duration2 years
Grant awarded29 July 2010
Start date1 September 2011
End date15 December 2013
Grant amount£112,923.00
Grant codeSP4558, GN1779

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The project leader, Dr Denise McDonald and her colleague, Dr Tom Gardiner, have extensive expertise in the biological processes that take place within the eye’s light-sensitive retina and the blood vessels that nourish it. Both researchers are well established and respected internationally.

The research is taking place in the internationally recognised Centre for Vision and Vascular Research, at Queen’s University Belfast. The centre is well equipped and generates a very significant research output in vascular biology and retinal disease

Who stands to benefit from this research and how?

Hopes of better treatment

The researchers aim to help premature babies who are at risk of losing their vision to ROP. The youngest, sickest and smallest premature babies are most at risk. That includes over 3,000 babies who are born more than 12 weeks early each year in the UK.4

Much of the research into new treatments for ROP focuses on helping babies whose disease is already quite advanced. This research, in contrast, has the ultimate aim of finding a preventative treatment, which stops ROP from developing in the first place.

The researchers are studying how ROP develops within the eye and investigating whether certain natural substances, called cofactors, show promise as a possible treatment. The fact that cofactors are present naturally in the human body could help speed progress towards clinical trials in ROP.

The incidence of ROP seems to be increasing in many parts of the world.3 All too many children are having to face up to a lifetime of vision problems or even blindness. The demand for a better treatment, which saves more children’s sight, without causing side effects, is high.

References

  1. National Eye Institute, National Institutes of Health, USA. Facts about retinopathy of prematurity (ROP). Website accessed 19 October 2010. http://www.nei.nih.gov/health/rop/rop.asp
  2. Drack A. Retinopathy of Prematurity. Adv Pediatr 2006; 53:211-26.
  3. MedlinePlus. Retinopathy of Prematurity. Website accessed 19 October 2010. http://www.nlm.nih.gov/medlineplus/ency/article/001618.htm
  4. Office of National Statistics. Preterm births 2005. http://www.statistics.gov.uk/statbase/Product.asp?vlnk=14882 Website accessed 5th Nov 2010
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