Risk of blindness among premature babies with low levels of blood platelets
Premature babies with low levels of platelets (thrombocytes) in their blood run a greatly increased risk of being afflicted with a severe variation of retinopathy of prematurity (ROP), an eye disease that can cause blindness, according to a study published in the journal JCI Insight. In experiments on mice, injections of blood platelets reduce the pathological development of retinal vessels.
“I believe this paves the way for completely new therapeutic possibilities and also for new research domains for both pathological and normal vascular development,” says Ann Hellström, professor of pediatric ophthalmology at Sahlgrenska Academy, University of Gothenburg and a chief physician at Sahlgrenska University Hospital.
Every year, about a thousand children in Sweden are screened for retinopathy of prematurity (ROP). The disease mainly affects children born before 28 weeks of pregnancy whose retinal vessels have not finished growing at birth. The children run the risk of permanent vision impairment and, in severe cases, blindness due to retinal detachment.
Fourfold increased risk
The current study points to a correlation between low levels of platelets, whose main task in adults is to inhibit bleeding in blood vessels, and a fourfold increased risk of severe ROP in infants. Observational studies on 202 premature babies with ROP have been conducted in Gothenburg and Stockholm.
The experimental parts of the study, conducted at Harvard Medical School in Boston, indicate that pathological vascular development in the retina of young mice increased by 30 percent when antibodies lowered platelet levels. When platelets from adult mice were introduced instead, the pathological vascular development declined by 19 percent.
“Platelets in the bloodstream contain factors like nannies for vascular development. But babies born prematurely consume much of their platelets in connection with infections, and an imbalance of these factors arises in the bloodstream and out in the tissue that can lead to pathological vascular development, in this case in the retina,” Ann Hellström explains.
New potential strategy
Ann Hellström and her colleague in Boston, Lois Smith, maintain that the study's findings point to a new direction and potential strategy for treating premature infants at risk of vision impairment caused by ROP.
“Purely hypothetically, it’s conceivable that a transfusion of platelets could be administered to restore balance and calm everything down if there are signs of a growth of pathological blood vessels if the child is found to have low levels of platelets,” Ann Hellström says.
Title: Thrombocytopenia is associated with severe retinopathy of prematurity
Images: Screening for ROP at Sahlgrenska University Hospital (photo: Ann-Sofie Petersson) and portrait of Ann Hellström (photo: Margareta G Kubista)