Retinopathy of prematurity affects about 15,000 newborns a year.

Study: Disease-fighting T cells hold promise of treatment for preemies born with eye condition

A novel study on disease-attacking white blood cells, called regulatory T cells (Tregs), in the retina could provide hope for premature babies and diabetic adults with neovascular retinopathies.

“This study also underscores another very important reason why comprehensive eye exams are needed every year to detect the very beginning stages of these diseases, so that the advanced treatment options could be implemented before there is severe retinal damage.”

The study by researchers at Monash University in Australia was published in a Sept. 29 article online in Nature Communications. The study sought to determine if a boost in T cells in the retina would reduce the disorganized, compensatory growth of new blood vessels (called neovascularization) in retinopathy of prematurity (ROP). The growth can cause the blood vessels to leak and scar the retina. In some instances, the retina may detach.

In their study, researchers found that an insufficient number of T cells were reaching the preemies' retinas due to the neovascularization. Recruited to the retina in their mice studies, however, the T cells reduced the vasculature, they say.

"Here we show that the expansion of Treg numbers results in their penetration into retinal tissue and a reduction in vision-threatening retinopathy, including vaso-obliteration, neovascularization, and vascular leakage," the researchers say. "These results indicate that harnessing the immunosuppressive capacity of Tregs is a potential therapy for the treatment of neovascular retinopathies."

Neovascular retinopathies include ROP, diabetic retinopathy and age-related macular degeneration. According to the National Eye Institute (NEI), ROP can cause blindness in underweight babies (under three pounds) born before 31 weeks of gestation and is one of the most common causes of vision loss in children worldwide. Of the 3.9 million babies born annually in the U.S., about 15,000 have some form of ROP, the NEI says.

It's estimated that of 285 million people with diabetes mellitus worldwide, about one third have signs of diabetes retinopathy.

What this means for patients, doctors of optometry.

Jennifer Zolman, O.D., is co-chair of the AOA's InfantSEE® and Children's Vision Committee. Dr. Zolman practices with the Draisin Vision Group in Charleston, South Carolina.

"The significance of this study for patients is that there may be another answer for neovascular retinopathies, besides current treatment options (such as laser photocoagulation) that often can cause permanent damage to their retinas," Dr. Zolman says.

"The study was based on oxygen-induced retinopathy," she added. "But it also may be an answer, down the road, for other neovascular retinopathies, such as diabetic retinopathy and macular degeneration. The amplified amount of Tregs would reduce the severe microvascular retinal diseases, saving the retina from severe damage and keeping patients from losing sight."

For doctors of optometry, the study suggests more options.

"The significance for doctors of optometry would be a better treatment option for their patients," Dr. Zolman says. "It would mean less damage to the babies that have ROP and better outcomes for their visual potential in life."

She adds: "This study also underscores another very important reason why comprehensive eye exams are needed every year to detect the very beginning stages of these diseases, so that the advanced treatment options could be implemented before there is severe retinal damage."

Potentially. More studies are being planned.

"There could be some interesting potential to this study," Dr. Zolman says. "The study is still in the very early stages of mice and in vitro. It will be interesting to see the results if it makes it to human studies."

October 11, 2017

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