To investigate levels of specific plasma-biomarkers related to neurodegeneration and inflammation in patients with different chronic degenerative retinal diseases, using an ultrasensitive technology called ‘single molecule array’ (SiMoA). Also, to investigate if biomarkers were measurable in the patient’s blood, dependent on age and medical comorbidities, and useful for stratifying the diseases. This exploratory, cross-sectional study recruited 151 adults at the Department of Ophthalmology, Rigshospitalet, Denmark (period 2019 to 2020). Clinical data came from the electronic medical-record system. The study population consisted of 131 patients: 32 with diabetic retinopathy (DR; 51 diabetes, DM), 27 with glaucoma, 53 with inherited retinal degeneration (IRD and 20 healthy controls (HC). Medical comorbidities included organ failure, other active eye diseases, and comorbidities. Three biomarkers, neurofilament-light-chain (NFL), glial-fibrillary-acidic-protein (GFAP), and CXC-motif chemokine ligand 13 (CXCL13), were measured with SiMoA technology. The age-adjusted values were reported as fold differences (FD) with 95% confidence intervals (CI). Increased NFL levels were found in DR patients compared to HCs (FD 1.81 95%CI 1.43, 2.28, p < 0.001, adj-p < 0.001). Similarly increased NFL levels were reported in advanced DR (PDR, DME), compared to both DM (FD 2.52 (95%CI: 1.71; 3.72, p < 0.001, adj-p < 0.001, and FD 2.04 (95%CI: 1.33; 3.12, p < 0.001, adj-p < 0.001), respectively) and HCs (FD 2.35 (95%CI: 1.67; 3.30, p < 0.001, adj-p < 0.001), and FD 1.89 (95%CI: 1.28; 2.79, p < 0.001, adj-p < 0.001) respectively). Independent of comorbidities, decreased NFL-levels were seen in IRD compared to DR (FD 0.49 (95% CI 0.39; 0.61, p < 0.001; adj-p < 0.001), ±comorbidities). Decreased GFAP levels were seen in DM patients compared to HCs (FD 0.69; 95%CI 0.55, 0.87, p = 0.002, adj-p = 0.02), but contrary to an increasing trend in advanced DR compared to DM (-comorbidities). These results imply that these biomarker-tests are useful for detecting and monitoring development of retinopathy in the circulations of diabetes patients. Plasma-biomarkers may be useful to stratify between retinal disease types. Prospective studies are underway to explore this hypothesis in depth.

Purpose: Children born preterm are believed to be at increased risk of visual impairment (VI). The increased survival rate of extremely preterm children may have changed the spectrum of diseases occurring postnatally. The aim of this study was to analyse the prevalence and causes of VI in an ex‐preterm Danish population during the last 4 decades.Methods: The study was based on the National Register of Blind and Visually Impaired Children (NRVIC). Ex‐preterms born at gestational age (GA) <32 weeks and enrolled in NRVIC at any time between 1988 and 2020 were included. The main cause of VI, the severity of VI and systemic comorbidities were analysed for temporal changes.Results: A total of 335 patients were included. The prevalence of VI decreased from 26/1000 preterm children in the 1980s to 15/1000 in 2000s. Blindness due to preterm birth is almost eliminated affecting 1/1000 today. Sequelae to retinopathy of prematurity (ROP) was the most common cause of VI (51% of cases) in the 1980s but decreased to 34% in 2010s, whereas non‐ocular causes of VI increased from 1% to 36%, respectively. More than half of the children (64%) had combined comorbidities and 36% had isolated VI.Conclusion: The improved monitoring in neonatal intensive care units and management of ROP has reduced the prevalence of severe VI due to ROP and almost eliminated blindness over the last decades in Denmark. However, preterm children are still at risk of non‐ocular causes of VI and comorbidities following the premature delivery.

Objectives: This study investigates the feasibility of implementing telescreening for retinopathy of prematurity (ROP) using the ICON GO^® widefield camera operated by a non-physician healthcare professional (NPHP). We hypothesized that images captured by an NPHP are adequate to evaluate ROP changes without further examinations. Secondly, the level of agreement between independent ROP graders were evaluated based on the fundus photographs. Methods: National ROP screening criteria were gestational age (GA) < 32 weeks or birthweight (BW) < 1500 g. Exclusion criteria were children hospitalized and born outside the Capital Region and examinations not performed by an NPHP. The screenings were performed using the ICON GO^®. The NPHP selected the best images for evaluation by an on-site ophthalmologist, regarding whether re-examination was necessary and if so, whether the re-examination was beneficial. Lastly, the images were re-evaluated by an independent off-site ophthalmologist. Results: A total of 415 screening sessions on 165 patients performed by an NPHP were included. Re-examination was necessary in three screening sessions and beneficial in two. The level of agreement between the on-site and off-site ophthalmologists regarding ROP screening outcome was k = 0.82, ROP stage k = 0.69, plus disease k = 0.69, and lastly ROP zone k = 0.37. Of the screened children, ninety-seven (58.8%) had no ROP at any time points, sixty-two (37.6%) had some stage of ROP not requiring treatment, and six (3.6%) received ROP treatment. Conclusions: Telemedicine screening for ROP with the ICON GO^® camera performed by an NPHP was feasible with an almost-perfect agreement and negligible need for re-examinations. The approach effectively identified children needing treatment, supporting the use of telescreening in ROP management.

Purpose: Preterm birth is associated with a risk of ocular complications. The primary aim of the study was to evaluate the main cause of visual impairment (VI) in a cohort of preterm born patients who had childhood‐onset VI. The association between health‐related quality of life (HRQoL) and age, cause—and severity of VI and impairment type was assessed.Methods: In Denmark, patients <18 years with VI are enrolled at the National Danish Registry of Children with Visual Impairment (NDRCVI). Patients born preterm and enrolled at NDRCVI at any time between 1988 and 2020 were invited for a follow‐up regardless of current age. Examinations performed were visual acuity (VA), refraction, Goldmann visual fields, ocular biometry and posterior segment imaging. The three main outcomes were VA sorted by VI severity (mild, moderate, severe and blind), a score for HRQoL (HUI3) and the main cause of VI.Results: Thirty‐two preterm‐born patients participated in the study with a median age of 28 years at examination (range 8–43). ROP was the main cause of VI in 15 patients (47%) followed by CVI in eight patients (25%). Increasing age at assessment had a significantly negative impact on the HRQoL‐score, when unadjusted for type of impairments. HRQoL was significantly lower in patients with combined impairments compared to isolated VI (p = 0.003).Conclusion: ROP and CVI were the most common causes of VI. The HRQoL was significantly lower when VI was combined with other impairments in contrast to isolated VI. Reducing cerebral damage in preterm born children is likely to enhance both HRQoL and visual function.