- Email: [email protected]
A call to end retinopathy of prematurity
Accepted Manuscript A call to end retinopathy of prematurity William V. Good, MD PII:
S1091-8531(16)30615-2
DOI:
10.1016/j.jaapos.2016.11.001
Reference:
YMPA 2516
To appear in:
Journal of AAPOS
Received Date: 31 October 2016 Accepted Date: 3 November 2016
Please cite this article as: Good WV, A call to end retinopathy of prematurity, Journal of AAPOS (2016), doi: 10.1016/j.jaapos.2016.11.001. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
ACCEPTED MANUSCRIPT
Editorial A call to end retinopathy of prematurity William V. Good, MD
RI PT
Author affiliations: Smith-Kettlewell Eye Research Institute, San Francisco, California Correspondence: William V. Good, MD, Smith-Kettlewell, 2318 Fillmore St., San Francisco, CA 94115 (email: [email protected]).
AC C
EP
TE D
M AN U
SC
Word count: 491
ACCEPTED MANUSCRIPT
This edition of the Journal focuses partly on retinopathy of prematurity (ROP), in the form of a mini-symposium. A revolution in the diagnosis, management, and prevention of ROP is slowly eroding this devastating condition. Over 90% of premature infants with
RI PT
the worst possible disease can expect a favorable structural outcome in Western countries. The National Eye Institute/National Institutes of Health has presciently invested and
participated in ROP research, with significantly positive results. A new medical treatment
SC
(bevacizumab and other forms of vasculogenesis inhibitors) may make treatment less
stressful for these fragile infants. New diagnostic techniques are hopeful, and others are
M AN U
on the horizon.
Emerging economies have become a focus for management efforts. Underresourced areas desperately need less expensive and more accessible treatment options. In some regions of the world larger and more mature premature infants develop advanced
TE D
ROP. Some regions lack trained staffing, functional equipment, and even a rudimentary understanding of ROP in all its myriad forms. Management patterns that work in the West may not always apply to other regions. Therefore, we need a way to prevent ROP
EP
so that treatment becomes obsolete. Ultimately, ROP will be prevented by eliminating or at least forestalling prematurity. Until this occurs, research on the use of insulin-like
AC C
growth factor, beta-blockers, and many other techniques is promising. This edition features contributions by Michael Chiang, Helen Mintz-Hittner,
David Wallace, and many others. Chiang reviews telemedicine, a technique that holds promise in areas where trained examiners are not available. Mintz-Hittner, whose unique, sometimes controversial, work on bevacizumab has swept the country and changed the way many physicians treat advanced ROP, offers her perspective on VEGF-inhibitors for
ACCEPTED MANUSCRIPT
ROP. Wallace offers a balanced viewpoint on what we need to do to evaluate different approaches to treat ROP. As chair of PEDIG, he has helped to move that organization into the ROP realm. The symposium represents an effort to bring disparate ideas under
RI PT
one roof, so that the reader gets a feel for ongoing research efforts. In so doing, we
recognize the significant efforts by colleagues like Graham Quinn Lois Smith, and many, many others whose work appears from time to time in J AAPOS and other leading
SC
journals.
Many questions remain unanswered. How do we prevent the consequences of
M AN U
ROP (eg, high refractive errors and reduced visual acuity even in the setting of favorable structural outcomes)? Are VEGF inhibitors safe, and, if so, at what doses? What are the best strategies to end ROP entirely?
Many of us practiced before the advent of ablative therapy for ROP and watched
TE D
as countless infants were left sightless by this devastating disease. We are fortunate to have a community of scientists devoted to working on a leading cause of blindness in children. Look how far we have come, thanks to the hard work of so many. It’s time to
EP
consider the real possibility that this condition can be eliminated. When that happens, we
AC C
will have achieved nothing short of a miracle.
S1091-8531(16)30615-2
DOI:
10.1016/j.jaapos.2016.11.001
Reference:
YMPA 2516
To appear in:
Journal of AAPOS
Received Date: 31 October 2016 Accepted Date: 3 November 2016
Please cite this article as: Good WV, A call to end retinopathy of prematurity, Journal of AAPOS (2016), doi: 10.1016/j.jaapos.2016.11.001. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
ACCEPTED MANUSCRIPT
RI PT
Author affiliations: Smith-Kettlewell Eye Research Institute, San Francisco, California Correspondence: William V. Good, MD, Smith-Kettlewell, 2318 Fillmore St., San Francisco, CA 94115 (email: [email protected]).
AC C
EP
TE D
M AN U
SC
Word count: 491
ACCEPTED MANUSCRIPT
This edition of the Journal focuses partly on retinopathy of prematurity (ROP), in the form of a mini-symposium. A revolution in the diagnosis, management, and prevention of ROP is slowly eroding this devastating condition. Over 90% of premature infants with
RI PT
the worst possible disease can expect a favorable structural outcome in Western countries. The National Eye Institute/National Institutes of Health has presciently invested and
participated in ROP research, with significantly positive results. A new medical treatment
SC
(bevacizumab and other forms of vasculogenesis inhibitors) may make treatment less
stressful for these fragile infants. New diagnostic techniques are hopeful, and others are
M AN U
on the horizon.
Emerging economies have become a focus for management efforts. Underresourced areas desperately need less expensive and more accessible treatment options. In some regions of the world larger and more mature premature infants develop advanced
TE D
ROP. Some regions lack trained staffing, functional equipment, and even a rudimentary understanding of ROP in all its myriad forms. Management patterns that work in the West may not always apply to other regions. Therefore, we need a way to prevent ROP
EP
so that treatment becomes obsolete. Ultimately, ROP will be prevented by eliminating or at least forestalling prematurity. Until this occurs, research on the use of insulin-like
AC C
growth factor, beta-blockers, and many other techniques is promising. This edition features contributions by Michael Chiang, Helen Mintz-Hittner,
David Wallace, and many others. Chiang reviews telemedicine, a technique that holds promise in areas where trained examiners are not available. Mintz-Hittner, whose unique, sometimes controversial, work on bevacizumab has swept the country and changed the way many physicians treat advanced ROP, offers her perspective on VEGF-inhibitors for
ACCEPTED MANUSCRIPT
ROP. Wallace offers a balanced viewpoint on what we need to do to evaluate different approaches to treat ROP. As chair of PEDIG, he has helped to move that organization into the ROP realm. The symposium represents an effort to bring disparate ideas under
RI PT
one roof, so that the reader gets a feel for ongoing research efforts. In so doing, we
recognize the significant efforts by colleagues like Graham Quinn Lois Smith, and many, many others whose work appears from time to time in J AAPOS and other leading
SC
journals.
Many questions remain unanswered. How do we prevent the consequences of
M AN U
ROP (eg, high refractive errors and reduced visual acuity even in the setting of favorable structural outcomes)? Are VEGF inhibitors safe, and, if so, at what doses? What are the best strategies to end ROP entirely?
Many of us practiced before the advent of ablative therapy for ROP and watched
TE D
as countless infants were left sightless by this devastating disease. We are fortunate to have a community of scientists devoted to working on a leading cause of blindness in children. Look how far we have come, thanks to the hard work of so many. It’s time to
EP
consider the real possibility that this condition can be eliminated. When that happens, we
AC C
will have achieved nothing short of a miracle.