Holmes Lecture

Holmes Lecture

Prof. Xiaoxin Li from the People Eye Center of Peking University People’s Hospital in China,

noted that the incidence of ROP increased in China after 1990 because at that time neonatal awareness was expanding and improving.

The use of unmonitored supplemental oxygen was common and some babies received oxygen unnecessarily.

To promote ROP prevention, Prof Li performed studies on the risks for ROP, wrote editorials in journals, provided training for ROP screening

and treatment, and held conferences with neonatal intensive care units (NICU) ลาวสามัคคี.

 Three ROP incidence studies in Beijing were done in 1993, 2002 and 2005, respectively, showing a decrease from 20.3% (1993) to 17.3% (2002) and 10.8% (2005).

“With the guideline for ROP screening in 2004, oxygen concentration control has been improved, but just in big hospitals. Birth weight remained at 1000-1500g.

 We realized that there had been an unbalanced improvement of NICU in China.

So, we requested the Ministry of Health hold a meeting with the NICU experts for discussion and then generated new guidelines separately,” she said.

The new ROP screening guidelines in 2014 included maintaining the screening criteria of 2004, with initial exams starting from 4-6 weeks after birth (gestational age 31-32 weeks).

Intervention criteria includes threshold lesion or pre-threshold lesion of Type 1, within 72 hours.

The guidelines also included follow-up intervals and criteria for stopping follow-up. To evaluate whether laser or anti-VEGF is better at treating ROP, Prof.

Li did a study and found that intravitreal bevacizumab (IVB) monotherapy, as compared with conventional laser therapy, showed significant benefits for infants with zone I ROP.

 However, no statistical differences were found for zone II lesions.

Unfavorable outcomes (progressing into stages 4 and 5) is 18.5% for the laser group, and 3.7% for the IVB group.

 It was also found that fibrosis occurred in the eye just one week after the administration of anti-VEGF.

Hence, Prof. Li and her team did a study on the relationship between anti-VEGF and fibrosis cells in order to obtain a better understanding of it.

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