Cure for blindness among premature infants identified

CORPUS CHRISTI – A disease that causes blindness in premature infants worldwide and is a scourge to thousands of newborns in underdeveloped countries could soon be wiped out like polio was in the 1950s. Retinopathy of Prematurity (ROP), the most common single cause of childhood blindness worldwide, can be eradicated with the injection of a drug into the eyes at the correct time. That’s the conclusion of a recent study that was spearheaded by Helen Mintz-Hittner, MD, FACS, professor of pediatric ophthalmology at the University of Texas Health Science Center-Houston Medical School.

“This is a worldwide game changer for ROP” said Dr. Mintz-Hittner, principal investigator of the study. “This is going to catch on rapidly very shortly.”

Dr. Mintz-Hittner will discuss her study in a presentation titled “The Possibility of Anti-Vascular Endothelial Growth Factor (VEGF) for Retinopathy of Prematurity (ROP)” during Driscoll Children’s Hospital’s grand rounds at 12:30 p.m. Oct. 1 in the hospital’s auditorium.

ROP is caused by the abnormal development of blood vessels in the retina affecting preterm infants. Among babies, the primary risk factor is prematurity; those that are very sick are most susceptible. Most babies who develop ROP weigh less than 3 lbs. at birth, but in underdeveloped countries they can weigh up to 5 lbs. For example, in India, there are 50,000 to 60,000 children who are blind due to ROP, Dr. Mintz-Hittner said.

“It’s a worldwide problem that is growing exponentially,” she said. “Cases are increasing because of the increased survival of premature infants with improvements in neonatal intensive care units.”

The standard procedure for treating ROP currently is operating on the retina using a laser. This comes with side effects: It obliterates a portion of the peripheral vision, can leave the patient near-sighted and often causes the development of crossed eyes.

In the study led by Dr. Mintz-Hittner, physicians tested a drug called Avastin, which is commonly used to treat cancer and eye disease in adults. Adults whose eyes were treated with Avastin had greatly improved vision. But the drug had never been used in an organized clinical trial to treat ROP in premature infants.

From March 2008 to August 2010, Dr. Mintz-Hittner and her colleagues compared results of Avastin treatment and laser treatment among babies in the first clinical trial of this kind. Fifteen medical centers across the US were involved in the clinical trial, including Driscoll Children’s Hospital, where almost 20 percent of the study’s babies were being cared for.

The study was the first to use a RetCam, a $100,000 machine at Driscoll that allows close-up examination of the retina, Dr. Mintz-Hittner said.

The study was conclusive: Injecting Avastin into the eyes of preterm infants at the proper time makes the vessels disappear that cause blindness in ROP and leaves the infants with normal vision.

“It’s like putting a needle into a grape,” Dr. Mintz-Hittner said. “It takes seconds for the eye to be cured. It can be done by anyone who is medically trained, so it has great potential in developing countries especially.”

Simply stated, Avastin decreases the chemical signal that stimulates the growth of abnormal blood vessels in the retina and allows them to grow out normally.

“This is a great step in the fight to improve the outcomes of our premature babies,” said Miguel De Leon, MD, medical director of Neonatology Consultants of Corpus Christi. “Our hope is that Dr. Mintz-Hittner’s research will one day allow us to save these babies without visual impairments due to ROP.”

Dr. Mintz-Hittner said she has been active in ROP research throughout her 36-year career. She has travelled all over the world explaining her latest study to audiences, including India, China, Canada, Germany and the Czech Republic. The study will soon be published, she said.

Driscoll Children’s Hospital is currently using Avastin to treat premature newborns. Dr. Mintz-Hittner anticipates that soon “everyone will start using it,” she said.

What: Grand rounds featuring Dr. Helen Mintz-Hittner and her presentation, “The Possibility of Anti-Vascular Endothelial Growth Factor (VEGF) for Retinopathy of Prematurity (ROP)”
When: 12:30 p.m. Friday, Oct. 1
Where: Driscoll Children’s Hospital auditorium, 3533 S. Alameda St.
Information: (361) 694-5335