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Correlation between Retinopathy of Prematurity and Levels of Proinflammatory Cytokines

Presented in Trisakti University July 2012 I Gusti Agung Ayu Widyarini 030.09.113




Retinopathy of Prematurity in The World
WHO: First cause of blindness in infants in developed and developing countries

Indonesia: First cause of blindness in preterm infants

Retinopathy of Prematurity
Vascular disorder of infants with gestational age less than 28 weeks and is accompanied by low birth weight

1. Shastry BS. Genetic susceptibility to advanced retinopathy of prematurity (ROP). J Biomed Sci 2010; 17:69.

Pathogenesis of ROP
Fails to limit retinal oxygenation

Arrest in vascular development

The regrowth becomes overstated, deregulated, and misguide

1. Sapieha P, Joyal JS, Rivera JC, Duchemin EK, Sennlaub F, Hardy P, et al. Retinopathy of prematurity: understanding ischemical retinal vasculopathies at an extreme of life. JCI 2010; 120(9): 3022-30.

Stages of ROP

1. Piscitelli. Different stages of retinopathy of prematurity. Accessed in June, 28th 2012. Available at: URL:

Cytokine: The Amazing Protein
Adaptive Innate Hematop oiesis

Cytokines are proteins secreted by the cells of innate and adaptive immunity that mediate many of the functions of these cells, include hematopoietic cells

1. Abbas AK, Lichtman AH, Pillai S. Cellular and molecular immunology. 6th ed. Philadelphia: Elsevier Saunders; 2007. p. 267-70.

Proinflammatory Cytokines in Plasma
Innate Immunity
• • • • • • • • • • TNF IL-1 Chemokines IL-12 IFN IL-10 IL-6 IL-15 IL-18 IL-23 • • • • • • •

Adaptive Immunity
IL-2 IL-4 IL-5 IFN-γ Lymphotoxin IL-13 IL-17

1. Abbas AK, Lichtman AH, Pillai S. Cellular and molecular immunology. 6th ed. Philadelphia: Elsevier Saunders; 2007. p. 267-70.




Correlation between ROP and Levels of Proinflammatory Cytokines

Proinflammatory cytokines TNF-α

1. Lee J, Dammann O. Perinatal infection, inflammation, and retinopathy of prematurity. Seminars in Fetal and Neonatal Medicine 2012: 26-9.

Study Year Subjects 877 preterm neonates with birth weight 4011000 gr 74 very low birth weight infants Duration of Intervention Result ↑ IL-6 ↑ CRP ↓ TGF-β, BDNF, NT-4 ↑ IL-6 ↑ IL-8 ↑ TNF-α

Sood et al


21 days

2005 Silveira et al 2007
1. 2.

27 months

Sood BG, Madan A, Saha S, Schendel D, Thorsen P, Skogstrand K, et al. Perinatal systemic inflammatory response syndrome and retinopathy of prematurity. Pediatric Research 2010; 67(4): 394-400. Silveira RC, Filho JBF, Procianoy RS. Assessment of the contribution of cytokine plasma levels to detect retinopathy of prematurity in very low birth weight infants. IOVS 2011; 52(3): 1297-300.




Retinopathy of prematurity is a vascular disorder that attacks the blood vessels of the retina in infants with premature birth and low birth weight

There are significant association between retinopathy of prematurity in the inflammatory process that triggers the secretion of proinflammatory cytokines

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