Blind World

Retinopathy of Prematurity.
ventilator study to save sight of babies.

December 30, 2004.

Scientists' breakthrough cuts eye danger to premature infants

SCIENTISTS have discovered a breakthrough method of preventing premature babies from going blind.

Researchers at Edinburgh University have found they can reduce the chance of blindness by slightly lowering the oxygen levels in ventilators used to keep such infants breathing.

Many babies go blind as a result of retinopathy of prematurity (ROP) which can be caused by the oxygen supply.

The eye disease occurs in babies born before full-term and is responsible for six per cent of childhood blindness.

But as a result of 71,000 in funding from Action Medical Research, scientists with the university's department of child life and health were able to explore why oxygen levels can have such devastating effects on eye development.

Premature babies are often born with breathing difficulties, so are often resuscitated using oxygen and helped to breathe using a ventilator, but the oxygen that helps the babies can also cause ROP.

The main characteristic of the disease is the growth of retinal blood vessels in the middle of the eye. In severe cases the retina can become detached.

The team found that both high and variable levels of oxygen reduce the amount of muscle and special supporting cells in the walls of blood vessels in the retina. The result is that the amount of blood vessels is increased, causing scarring on the retina, which can impair vision.

Following the study, doctors will now be able to reduce the likelihood of a baby developing ROP by slightly lowering oxygen levels.

Professor Neil McIntosh, who headed the research, said: "The implication for this in our babies is clear. We need to manage them at slightly lower oxygen levels, which is easy to do.

"We also need to maintain their stability. This is more difficult, so that is the area we will be concentrating our clinical research on in the future."

The oxygen the babies receive from their ventilators is variable, and the research has shown that the more severe forms of retinopathy are related to varying levels of oxygen in the babies' blood vessels during the first two weeks after birth.

Another unexpected result of the research has been the finding that special cells in the nervous system called astrocytes may also be involved in the development of ROP.

It is hoped that learning more about these cells and how they work may result in possible new treatments.

Action Medical Research chief executive Simon Moore said: "I am delighted that this research project has made such progress. Action Medical Research has a track record of funding research that takes genuine steps forward in knowledge. The results from the team in Edinburgh should help doctors do their best for the smallest babies for years to come."

Action Medical Research was founded more than 50 years ago in a bid to find a polio vaccine.

Other achievements include the development of pioneering hip replacement surgery, the testing of the first rubella vaccine, discovering the importance of folic acid in the prevention of spina bifida, and many other breakthroughs in the diagnosis and treatment of epilepsy, diabetes and premature babies.

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