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Retinal microvascular plasticity in a premature neonate

Published online by Cambridge University Press:  31 January 2017

Y. Kandasamy ,
L. Hartley  and
R. Smith
Y. Kandasamy*
Affiliation:
Department of Neonatology, The Townsville Hospital, Townsville, QLD, Australia Mothers and Babies Research Centre, Hunter Medical Research Institute, John Hunter Hospital, The University of Newcastle, Callaghan, NSW, Australia College of Medicine and Dentistry, The James Cook University, Townsville, QLD, Australia
L. Hartley
Affiliation:
Department of Optometry and Vision Science, The University of Melbourne, Melbourne, VIC, Australia
R. Smith
Affiliation:
Mothers and Babies Research Centre, Hunter Medical Research Institute, John Hunter Hospital, The University of Newcastle, Callaghan, NSW, Australia
*
*Address for correspondence: Y. Kandasamy, Department of Neonatology, The Townsville Hospital, 100 Angus Smith Drive, Douglas, QLD 4814, Australia. (Email Yoga.Kandasamy@health.qld.gov.au)
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Abstract

Dilation and abnormal tortuosity of retinal vessels are the hallmarks of severe retinopathy of prematurity (ROP) in premature infants. The stages of ROP are defined by vessel appearance at the interface between the vascular and avascular retinal areas. Deregulated signaling pathways involving hypoxia-inducible factors such as vascular endothelial growth factor (VEGF) are involved in the pathogenesis of ROP. VEGF-antagonists are increasingly being used as ‘off-label medication’ to treat this condition, with some success. We present Baby SM (female), who was born prematurely at 24 weeks gestation in a tertiary neonatal intensive care unit, and with a birth weight of 640 g. On screening at 35 weeks postmenstrual age (PMA), she was noted to have ROP, which became severe by 37 weeks PMA. She received one dose of intravitreal VEGF antagonist (Bevacizumab), resulting in a decrease in vessel tortuosity and dilation. However, repeat imaging at 4 weeks showed a re-emergence of vessel tortuosity. We believe the observed changes demonstrate an inherent retinal microvascular plasticity in premature neonates. With improved survival of extremely premature neonates and the availability of retinal imaging technology, we are now able to observe this plasticity.

Keywords

neonateplasticityprematurepretermretinal microvascular
Type
Brief Report
Information
Journal of Developmental Origins of Health and Disease , Volume 8 , Issue 3 , June 2017 , pp. 284 - 286
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Copyright
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2017 

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