دورية أكاديمية
أعرض في EDS

The Effect of Perinatal High-Dose Erythropoietin on Retinal Structural and Vascular Characteristics in Children Born Preterm.

التفاصيل البيبلوغرافية
العنوان: The Effect of Perinatal High-Dose Erythropoietin on Retinal Structural and Vascular Characteristics in Children Born Preterm.
المؤلفون: Jeltsch BM; From the Department of Ophthalmology (B.M.J., J.V.M.H., L.S., C.G-K.), University Hospital Zurich and University of Zurich, Zurich, Switzerland., Hanson JVM; From the Department of Ophthalmology (B.M.J., J.V.M.H., L.S., C.G-K.), University Hospital Zurich and University of Zurich, Zurich, Switzerland., Füglistaler J; Department of Biostatistics, Epidemiology, Biostatistics and Prevention Institute (J.F., R.H.), University of Zurich, Zurich, Switzerland., Heyard R; Department of Biostatistics, Epidemiology, Biostatistics and Prevention Institute (J.F., R.H.), University of Zurich, Zurich, Switzerland., Sisera L; From the Department of Ophthalmology (B.M.J., J.V.M.H., L.S., C.G-K.), University Hospital Zurich and University of Zurich, Zurich, Switzerland., Wehrle FM; Department of Neonatology and Pediatric Intensive Care (F.M.W., C.F.H), University Children's Hospital Zurich, Zurich, Switzerland., Hagmann CF; Department of Neonatology and Pediatric Intensive Care (F.M.W., C.F.H), University Children's Hospital Zurich, Zurich, Switzerland., Fauchère JC; Department of Neonatology (J-C.F.), University Hospital Zurich and University of Zurich, Zurich, Switzerland., Gerth-Kahlert C; From the Department of Ophthalmology (B.M.J., J.V.M.H., L.S., C.G-K.), University Hospital Zurich and University of Zurich, Zurich, Switzerland. Electronic address: Christina.gerth-kahlert@usz.ch.
المصدر: American journal of ophthalmology [Am J Ophthalmol] 2024 Jun 14; Vol. 266, pp. 264-273. Date of Electronic Publication: 2024 Jun 14.
Publication Model: Ahead of Print
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier Science Country of Publication: United States NLM ID: 0370500 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-1891 (Electronic) Linking ISSN: 00029394 NLM ISO Abbreviation: Am J Ophthalmol Subsets: MEDLINE
أسماء مطبوعة: Publication: 1999- : New York, NY : Elsevier Science
Original Publication: [Chicago, etc., Ophthalmic Pub. Co., etc.]
مستخلص: Purpose: To study the long-term effects of perinatal high-dose recombinant human erythropoietin (rhEPO) on macular structural and vascular development in preterm children.
Design: Randomized, double-blind clinical trial follow-up plus cohort study.
Methods: Setting: Department of Ophthalmology, University Hospital Zurich, Zurich, Switzerland.
Study Population: extremely or very preterm born children aged 7-15 years from an ongoing neuropediatric study (EpoKids). These had been previously randomized to receive either high-dose rhEPO or placebo perinatally.
Inclusion Criteria: participation in the EpoKids Study, written informed consent (IC).
Exclusion Criteria: previous ocular trauma or surgery; retinal or developmental disease unrelated to prematurity. Term-born children of comparable age were enrolled as a healthy control (HC) group.
Inclusion Criteria: term birth, IC.
Exclusion Criteria: any ocular or visual abnormality, high refractive error. Examiners were blinded regarding intervention status until completion of all analyses. (Participants/guardians remain blinded).
Observation Procedures: Spectral-domain OCT scans (Heidelberg Spectralis system) and OCTA imaging (Zeiss PlexElite 9000) were obtained. Ophthalmological and orthoptic examinations excluded ocular comorbidities.
Main Outcome Measures: OCT (central retinal thickness, CRT; total macular volume, TMV), superficial plexus OCTA (foveal avascular zone, FAZ; vessel density, VD; vessel length density, VLD) parameters and foveal hypoplasia grade according to published criteria.
Results: Macular vessel density parameters (VD and VLD) were significantly lower (p =0.015, CI-95: 0.01 to 0.06 and p=0.015, CI-95: 0.74 to 3.64) in the EPO group (n= 52) when compared to placebo (n=35). No other significant differences were observed between the EPO and placebo group. When comparing the intervention subgroups to HC we found six significant differences in OCT and OCTA parameters (FAZ, VD, VLD and CRT comparing HC and EPO group; FAZ and CRT when comparing HC and placebo group).
Conclusions: Early high-dose rhEPO in infants born extremely or very preterm affects macular vessel density parameters compared to placebo. Premature birth (regardless of intervention status) affects retinal structure and vascular development. Our findings on macular vascular development do not contraindicate the administration of early high-dose EPO in preterm infants. For further understanding of the role of EPO on macular development and its clinical significance, future studies are needed.
(Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)
تواريخ الأحداث: Date Created: 20240616 Latest Revision: 20240720
رمز التحديث: 20240721
DOI: 10.1016/j.ajo.2024.06.005
PMID: 38880371
قاعدة البيانات: MEDLINE
الوصف
تدمد:1879-1891
DOI:10.1016/j.ajo.2024.06.005