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Retinopathy of Prematurity Lab
早產嬰兒視網膜病變實驗室

Overview 概述

Retinopathy of prematurity(ROP) is the leading cause of preventable childhood blinding disease globally. Low birth weight and prematurity are strongly associated with an increased risk of the disease. Infant born prematurely have incompletely vascularized retina with a peripheral avascular zone. ROP development is thought to be a biphasic pathologic neovascularization process involving an aberrant production of vascular endothelial growth factor (VEGF). With this understanding, the treatment for advanced ROP has moved from the destructive retinal laser ablation to the use of the anti-VEGF injection. This paradigm shift of management approach has resulted remarkable improvement of the outcome of the ROP infant especially the more advanced cases.

早產兒視網膜病變 (ROP) 是全球可預防的兒童致盲疾病的主要原因。低出生體重和早產與患病風險增加密切相關。早產嬰兒的視網膜血管不完全，周圍有無血管區。 ROP 發展被認為是一種雙相病理性新血管形成過程，涉及血管內皮生長因子 (VEGF) 的異常產生。有了這種認識，晚期 ROP 的治療已經從破壞性視網膜激光消融轉移到使用抗 VEGF 注射。這種管理方法的範式轉變顯著改善了 ROP 嬰兒的結果，尤其是更高級的病例。

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Despite the improvement treatment outcome, there are still gaps in the understanding and management of this condition.

儘管治療結果有所改善，但對這種情況的理解和管理仍存在差距。

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Our combined team of clinician and basic scientist are active in the pursuit of research in this field, focusing on improvement of understanding of the pathophysiology of the disease, diagnosis, surgical management, and investigating alternate treatment approach such as nutritional supplement.

我們由臨床醫生和基礎科學家組成的聯合團隊積極致力於該領域的研究，專注於提高對疾病病理生理學、診斷、手術治療的理解，並研究替代治療方法，例如營養補充劑。

 

From the clinical perspective 從臨床角度
Professor Lam has the clinical researches 林教授的臨床研究有：

  • Investigating alternate diagnostic protocol for early and more accurate diagnosis of ROP 研究替代診斷方案，以實現 ROP 早期和更準確的診斷

  • Established the pediatric widefield fluorescein angiography for improved diagnosis and monitoring of ROP and other pediatric retinal diseases (only facility in Hong Kong) 建立兒科寬視野熒光素血管造影術，以改善對 ROP 和其他兒科視網膜疾病的診斷和監測（香港唯一的設施）

  • Participate in international multi-center clinical trial for the use of anti-VEGF treatment of ROP 參與抗VEGF治療ROP的國際多中心臨床試驗

  • Provide world class surgical expertise and developing improve surgical techniques to tackle the management of complicated stage 4 and 5 ROP 提供世界一流的外科專業知識並開發改進的外科技術，以應對複雜的 4 期和 5 期 ROP 的管理

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Our basic research team led by Dr. Amy Lo has 我們由勞卓妍博士領導的基礎研究團隊擁有：

  • Established oxygen-induced retinopathy (OIR), an animal model of ROP – first and only one in Hong Kong 建立氧致視網膜病變 (OIR)，一種 ROP 的動物模型 – 香港首個也是唯一一個

  • Identified therapeutic potential of aldose reductase inhibition in the treatment of ROP 確定醛糖還原酶抑制治療 ROP 的治療潛力

  • Reported the beneficial effects of lutein in promoting vascular regrowth in OIR 報告了葉黃素在促進 OIR 血管再生方面的有益作用

  • Investigated vascular pathophysiology and neuronal dysfunction in gestational diabetes-associated retinopathy of prematurity 研究妊娠期糖尿病相關早產兒視網膜病變的血管病理生理學和神經元功能障礙

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Clinical trials 臨床試驗

Open-label, randomized, two-arm, controlled study to assess the efficacy, safety, and tolerability of intravitreal (IVT) aflibercept compared to laser photocoagulation in patients with retinopathy of prematurity (ROP) 2019.

開放標籤、隨機、兩臂、對照研究，以評估玻璃體腔注射 (IVT) 阿柏西普與激光光凝相比在早產兒視網膜病變 (ROP) 2019 中的療效、安全性和耐受性。

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Publications 出版物

* Corresponding Author 通訊作者

  1. Tsang JKW, Wolf SA, Pompoes IM, Joussen AM, Lam WC, Yang D, Lo ACY. Potential Effects of Nutraceuticals in Retinopathy of Prematurity. Life. 2021;11(2):79. doi: 10.3390/life11020079

  2. Chiu HH, Wan MJ, Kertes PJ, Muni RH, Lam WC. Visual outcomes after treatment in pediatric patients with Coats’ disease. Can J Ophthalmol. 2019; 54(6):647-652. doi:10.1016/j.jcjo.2019.02.004

  3. Bata BM, Chiu HC, Mireskandari K, Ali A, Lam WC, Wan M. Long-term visual and anatomic outcomes following early surgery for Persistent Fetal Vasculature: A single-center, 20 year review. JAAPOS. 2019 Dec;23(6), 327.e1-327.e5.

  4. Sharma A, Ali A, Henderson RH, Patel CK, VandenHoven C, Lam WC. Accuracy of scleral transillumination techniques to identify infant ciliary body for sclerotomy and intravitreal injections.

  5. Tsang JKW, Liu J, Lo ACY: Vascular and Neuronal Protection in the Developing Retina: Potential Therapeutic Targets for Retinopathy of Prematurity. Int J Mol Sci. 2019 Sep 3;20(17). pii: E4321. doi: 10.3390/ijms20174321. Review. PMID: 31484463.

  6. Alabduljalil T, Westall CA, Reginald A, Farsiu S, Chiu SJ, Arshavsky A, Toth CA, Lam WC. Demonstration of anatomical development of the human macula within first 5 years of life using handheld OCT. Int Ophthalmol. 2019 July; 39(7):1533-1542. doi: 10.1007/s10792-018-0966-3.

  7. Gan NY, Lam WC. Special Consideration for pediatric vitreoretinal surgery. Taiwan J Ophthalmology. 2018 Oct-Dec,8 (4): 237-242.

  8. Gan NY, Lam WC. Retinal Detachment in the pediatric population. Taiwan J Ophthalmology. 2018 Oct-Dec;8(4): 222-236.

  9. Fu Z, Meng SS, Burnim SB, Smith LE, Lo ACY: Lutein facilitates physiological revascularization in a mouse model of retinopathy of prematurity. Clin Exp Ophthalmol. 2017 Jul;45(5):529-538. doi: 10.1111/ceo.12908. Epub 2017 Jan 29. PMID: 28002872.

  10. Fu Z, Nian S, Li SY, Wong D, Chung SK, Lo ACY: Deficiency of aldose reductase attenuates inner retinal neuronal changes in a mouse model of retinopathy of prematurity. Graefes Arch Clin Exp Ophthalmol. 2015 Sep;253(9):1503-13. doi: 10.1007/s00417-015-3024-0. PMID: 25921391.

  11. Liu J, Lai CHY, Lo ACY: Therapeutic strategies for retinopathy of prematurity. H K J Ophthalmol. 2015 19(1):8-15

  12. Lo ACY, Lai AKW, Fu ZJ: Stem cell therapy for retinopathy of prematurity. Anat Physiol. 2013;3:126. doi: 10.4172/2161-0940.1000126. Review.

  13. Fu ZJ, Li SY, Kociok N, Wong D, Chung SK, Lo ACY: Aldose reductase deficiency reduced vascular changes in neonatal mouse retina in oxygen-induced retinopathy. Invest Ophthalmol Vis Sci 2012 Aug 20;53(9):5698-712. doi: 10.1167/iovs.12-10122. PMID: 22836764.

  14. Cheung CS, Butty Z, Tehrani NN, Lam WC. Computer-assisted imaging analysis of temporal retinal vessel width and tortuosity in retinopathy of prematurity for the assessment of disease severity and treatment outcome. J AAPOS. 2011 Aug;15(4):374-80.

  15. Kohly RP, Muni RH, Kertes PJ, Lam WC. Management of pediatric choroidal neovascular membranes with intravitreal ant-VEGF agents: a retrospective consecutive case series. Can J Ophthalmol.2011Feb;46(1):46-50.

  16. Robitaille JM, Zheng B, Wallack K, Beis MJ, Tatlidil C, Yang J, Sheidow TG, Siebert L, Levin AV, Lam WC, Arthur BW, Lyons CJ, Jaakkola E, Tsilou E, William CA, Weaver RG jr, Shield CL, Guernsey DL. The role of Frizzled-4 mutation in familial exudative vitreo-retinopathy and Coats disease. Br J Ophthalmol. Nov 21 2010.

  17. Adam RS, Kertes P, Lam WC. Observations on the management of Coats' disease: less is more. Br J Ophthalmol. 2007 Mar;91(3):303-6. Epub 2006 Oct 4.

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Books 書籍

Wu WC, Lam WC: A Quick Guide to Pediatric Retina/ Springer. 2021 (Editors)

Devenyi RG, Lam WC:  Paediatric Retinal Disease.  The Hospital for Sick Children Paediatric Ophthalmology Atlas, AV Levin, editor, 2006.

Lo, Amy Cheuk Yin.jpg

Professor Amy C.Y. Lo

勞卓妍教授

Principal Investigator 

首席研究員

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