Non-invasive approach may predict retinopathy of prematurity earlier

Research has found a new approach that identifies high-risk infants, so that not all preemies need to undergo an invasive eye exam. (Image Credit: Alexey Laputin /Adobe Stock).

Research conducted at the Ann & Robert H. Lurie Children’s Hospital of Chicago could detect retinopathy of prematurity (ROP), the most common cause of preventable lifelong blindness in children in the United States, while sparing a number of premature infants from undergoing invasive eye exams. ROP is caused by an abnormal development of small blood vessels on the retina.¹

A team of researchers led by Isabelle De Plaen, MD, discovered that imaging the capillaries in the nailbed of preemies within the first month of life using a non-invasive technique, called nailbed capillaroscopy, can identify infants at high risk for developing ROP. This screening could eliminate the need to evaluate all premature infants with eye exams about a month later. Findings were published in the Journal of Pediatrics.¹

De Plaen, senior author and neonatologist at Lurie Children’s, as well as professor of Pediatrics at Northwestern University Feinberg School of Medicine, explained that abnormal systemic vascular development starts much earlier than researchers had initially believed.¹

“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,” De Plaen said in the news release. “Earlier identification of these infants reduces the need to subject all premature babies to highly invasive eye exams.”

Moreover, De Plain said in the release the researchers’ results could 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% to 60% of babies with very low birth weight (less than 1,500g), according to the news release.¹

According to the news release, in the cohort of 32 premature neonates they studied, De Plaen and the research team 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,” De Plaen explained. “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.”

According to the news release, the research work 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.

Reference:

1. Daniel York, MD, Gustave H. Falciglia, MD, Elizabeth Managlia, PhD, David Kirchenbueckler, PhD, Consladina Anvanitis, PhD, Isabelle, G. De Plaen, MD. Nailfold Capillaroscopy: A Promising, Noninvasive Approach to Predict Retinopathy of Prematurity. Journal of Pediatrics. Published May 12, 2023. DOI: 10.1016/j.peds.2023.113478.