Levent KORKMAZ, Osman BASTUG, Tamer GUNES, Adnan OZTURK, Cagatay KARACA, Ahmet OZDEMİR, Selim KURTOGLU, Sabriye KORKUT

Prematüre retinopatisinde mean platelet volüm'un prediktif değeri olabilir mi?

Amaç: Prematüre retinopatisi retinanın damarsal bozukluğu sonucu oluşan proliferatif vitreoretinopati olup çocuklardaki körlüklerin sık nedenlerindendir. Özellikle hastalık patogenezinde, birbirinin zıttı olarak gerçekleşen fazların (birinci faz-vasoobliteration, ikinci faz-neovascularization) olduğunun bulunması prematüre retinopatisi hakkındaki düşüncelerin şekillenmesine yardımcı olmuştur. Prematüre retinopatisi yenidoğan ünitelerinde sonuçları açısından olduğu kadar takibi ve tedavisi açısından da oldukça önemli bir problemdir. Biz kontrollü klinik çalışmamızda, hem hastalığın takibinde kolaylık sağlayacak hem de hastalığın prognozunun tahmin edilmesinde klinisyenlere yol gösterecek basit bir yöntemi gündeme getirmek istedik. Gereç ve Yöntemler: Biz vaka kontrollü çalışmamızda, ROP riski altındaki 64 preterm olguyu, takipleri sonucu lazer fotokoagülasyon ihtiyacı duyulmuş 46 preterm olgu ile hastalığın birinci ve ikinci fazlarını göz önünde bulundurarak, bu fazlarda önemli rol oynayan vasküler endotelyal growth faktörün taşınması ve depolanmasında rol oynayan trombositler açısından değerlendirdik. Bulgular: Hastalığın birinci fazında, trombosit sayıları ve ortalama trombosit hacmi değerleri açısından kontrol ve lazer grupları arasında istatistiksel bir fark bulunmadı (p>0.05). Hastalığın İkinci fazında da kontrol ve lazer grupları arasında trombosit sayıları açısından istatsitiksel bir fark bulunmazken (p=0.98, p>0.05), aynı fazdaki ortalama trombosit hacmi değerleri açısından ise anlamlı fark bulundu (p=0.001, p

Can mean platelet volume have predictive value in premature retinopathy?

Aim: Retinopathy of prematurity, a proliferative vitreoretinopathy resulting from the vascular disorder of the retina, is the most frequent cause of blindness in childhood. In the pathogenesis of the disease, in particular, there are stages developing diametrically opposite to each other (the first phase vasoobliteration, the second phase neovascularization) helped our thoughts of the disease to form. Premature retinopathy is quite an important problem in newborn units not only as far as its consequences but also its follow-up and management. Our controlled clinical study aims to present a simple method that will facilitate the follow-up of the disease while guiding clinicians in predicting the prognosis of the disease. Material and Methods: In our case-controlled study we have assessed 64 preterm cases at the risk of premature retinopathy, considering both the 46 preterm cases having been realized at the follow-up to need laser photocoagulation, and the first and second stage of the disease, in terms of thrombocytes, which play an important part in the transport and storage of vascular endothelial growth factor. Results: No statistically significant difference was found between the control and laser groups in terms of the thrombocyte count and mean platelet volume values during the first stage of the disease (p>0.05). During the second stage of the disease, while no difference was detected between the control and laser groups in terms of the thrombocytes count, (p=0.98, p>0.05), Significant differences were found in mean platelet volume values (p=0.001, p

PDF

___

1. Gilbert C. Retinopathy of prematurity: a global perspective of the epidemics, population of babies at risk and implications for control. Early Hum Dev 2008;84(2):77-82.
2. Smith LE. Pathogenesis of retinopathy of prematurity. Growth Horm IGF Res 2004;14:140-44.
3. Italiano JE Jr, Richardson JL, Patel-Hett S, Battinelli E, Zaslavsky A, Short S. Angiogenesis is regulated by a novel mechanism: pro-and antiangiogenic proteins are organized into separate platelet alpha granules and differentially released. Blood 2008;111(3):1227-33.
4. Sapieha P, Joyal JS, Rivera JC, Kermorvant-Duchemin E, Sennlaub F, Hardy P. Retinopathy of prematurity: understanding ischemic retinal vasculopathies at an extreme of life. J Clin Invest 2010;120(9):3022-32.
5. Folkman J. Angiogenesis: an organizing principle for drug discovery? Nat Rev Drug Discov 2007;6(4):273-86.
6. Vinekar A, Hegde K, Gilbert C, Braganza S, Pradeep M, Shetty R. Do platelets have a role in the pathogenesis of aggressive posterior retinopathy of prematurity? Retina 2010;30(4):S20-3.
7. Jensen AK, Ying GS, Huang J, Karp K, Quinn GE, Binenbaum G. Thrombocytopenia and retinopathy of prematurity. J AAPOS 2011;15(1):e3-e4.
8. Ashton N. Retinal angiogenesis in the human embryo. Br. Med Bull 1970;26(2):103-6.
9. Smith LE. Pathogenesis of retinopathy of prematurity. Semin Neonatol 2003;8(6)469-73.
10. Browder T, Folkman J, Pirie-Shepherd S. The hemostatic system as a regulator of angiogenesis. J Biol Chem 2000;21;275(3):1521-4.
11. Pinedo HM, Verheul HM, D'Amato RJ, Folkman J. Involvement of platelets in tumour angiogenesis? Lancet 1998;28;352(9142):1775-7.
12. Wartiovaara U, Salven P, Mikkola H, Lassila R, Kaukonen J, Joukov V. Peripheral blood platelets express VEGF-C and VEGF which are released during platelet activation. Thromb Haemost 1998;80(1):171-5.
13. Kaplan DR, Chao FC, Stiles CD, Antoniades HN, Scher CD. Platelet alpha granules contain a growth factor for fibroblasts. Blood 1979;53(6):1043-52.
14. Ben-Ezra J, Sheibani K, Hwang DL, Lev-Ran A. Megakaryocyte synthesis is the source of epidermal growth factor in human platelets. Am J Pathol 1990;137(4):755-9.
15. Hla T. Physiological and pathological actions of sphingosine 1 phosphate. Semin Cell Dev Biol 2004;15(5):513-20.
16. Brian W. Fleck and neil mcIntosh. retinopathy of prematurity: recent developments. Neo Reviews 2009;10:20-30.
17. Sapieha P, Sirinyan M, Hamel D, Zaniolo K, Joyal JS, Cho JH. The succinate receptor GPR91 in neurons has a major role in retinal angiogenesis. Nat Med 2008;14(10):1067-76.
18. Alon T, Hemol, Itin A, Pe'er J, Stone J, Keshet E. Vascular endothelial growth factor acts as a survival factor for newly formed retinal vessels and has implications for retinopathy of prematurity. Nat Med 1995;1(10):1024-8.
19. Kermorvant-Duchemin E, Sapieha P, Sirinyan M, Beauchamp M, Checchin D, Hardy P. Understanding ischemic retinopathies: emerging concepts from oxygen-induced retinopathy. Doc Ophthalmol 2010;120(1):51-60.
20. Smith LE. Through the eyes of a child: understanding retinopathy through ROP the Friedenwald lecture. Invest Ophthalmol Vis Sci 2008;49(12):5177-82.
21. Dorrell MI, Aguilar E, Friedlander M. Retinal vascular development is mediated by endothelial filopodia, a preexisting astrocytic template and specific R-cadherin adhesion. Invest Ophthalmol Vis Sci 2002;43:3500-10.
22. Darlow BA, Hutchinson JL, Henderson-Smart DJ, Donoghue DA, Simpson JM, Evans NJ. Prenatal risk factors for severe retinopathy of prematurity among very preterm infants of the Australian and New Zealand Neonatal Network. Pediatrics 2005;115(4):990-6.
23. Roth AM. Retinal vascular development in premature infants. Am J Ophthalmol 1977;84(5):636-40.
24. Husain SM, Sinha AK, Bunce C, Arora P, Lopez W, Mun KS. Relationships between maternal ethnicity, gestational age, birth weight, weight gain, and severe retinopathy of prematurity. J Pediatr 2013;163(1):67-72.
25. Sun SC. Relation of target SpO2 levels and clinical outcome in ELBW infants on supplemental oxygen. Pediatr Res 2002;51:350.
26. Chen ML, Guo L, Smith LE, Dammann CE, Dammann O. High or low oxygen saturation and severe retinopathy of prematurity. Pediatrics 2010;125(6):e1483-92.
27. Askie LM, Henderson-Smart DJ, Irwig L, Simpson JM. Oxygen-saturation targets and outcomes in extremely preterm infants. N Engl J Med 2003;4;349:(10) 959-67.
28. SUPPORT Study Group of the Eunice Kennedy Shriver NICHD Neonatal Research Network. Target ranges of oxygen saturation in extremly preterm infants. N Engl J Med 2010;362:1959-69.
29. Leviton A, Dammann O, Engelke S, Allred E, Kuban KC, O'Shea TM. The clustering of disorders in infants born before the 28th week of gestation. Acta Paediatr 2010;99(12):1795-800.
30. Brennan R, Gnanaraj L, Cottrell DG. Retinopathy of prematurity in practice. I. Screening for threshold disease. Eye (Lond) 2003;17(2):183-8.
31. Lee J, Dammann O. Perinatal infection, infl ammation, and retinopathy of prematurity. Semin Fetal Neonatal Med 2012;17(1):26-9.
32. Chen J, Connor KM, Aderman CM, Willett KL, Aspegren OP, Smith LE. Suppression of retinal neovascularization by erythropoietin siRNA in a mouse model of proliferative retinopathy. Invest Ophthalmol Vis Sci 2009;50(3):1329-35.
33. Pierce EA, Avery RL, Foley ED, Aiello LP, Smith LE. Vascular endothelial growth factor/vascular permeability factor expression in a mouse model of retinal neovascularization. Proc Natl Acad Sci USA 1995;31;92(3):905-09.
34. Pierce EA, Foley ED, Smith LE. Regulation of vascular endothelial growth factor by oxygen in a model of retinopathy of prematurity. Arch Ophthalmol 1996;114(10):1219-28.
35. Checchin D, Hou X, Hardy P, Abran D, Najarian T, Beauchamp MH. PGE(2)-mediated eNOS induction in prolonged hypercapnia. Invest Ophthalmol Vis Sci 2002;43(5):1558-66.
36. Chemtob S, Hardy P, Abran D, Li DY, Peri K, Cuzzani O. Peroxide-cyclooxygenase interactions in postasphyxial changes in retinal and choroidal hemodynamics. J Appl Physiol (1985) 1995;78(6):2039-46.
37. D'Amore P, Shepro D. Stimulation of growth and calcium influx in cultured, bovine, aortic endothelial cells by platelets and vasoactive substances. J Cell Physiol 1977;92(2):177- 83.
38. Pipili-Synetos E, Papadimitriou E, Maragoudakis ME. Evidence that platelets promote tube formation by endothelial cells on matrigel. Br J Pharmacol 1998;125(6):1252-7.