
Graham E. Quinn
VerifiedUniversity of Pennsylvania · Rehabilitation Medicine
Active 1979–2026
About
Graham E. Quinn, MD, is an Emeritus Professor of Ophthalmology at the Perelman School of Medicine at the University of Pennsylvania. His research expertise includes retinopathy of prematurity, assessment of visual function and ocular development, and vision screening and treatment of amblyopia in young children. He has contributed to the development of techniques to assess disease and treatment modalities in infants and children at risk for severe retinopathy of prematurity. Dr. Quinn leads a large NEI-funded study on remote evaluation of digital images from premature infants, which has resulted in several publications. He is actively involved in international collaborations aimed at the prevention of blindness from retinopathy of prematurity.
Research topics
- Computer Science
- Machine Learning
- Artificial Intelligence
- Pathology
- Ophthalmology
- Mathematics
- Medicine
Selected publications
Optometry and Vision Science · 2026-02-01 · 1 citations
articleOpen accessMany children with a moderate amount of farsightedness do not see as well up close as children who are not farsighted, and they often have significantly more problems with near visual function (near visual acuity, stereoacuity, and accommodation), early literacy skills, reading, and attention. Problems with early literacy skills often lead to difficulties with reading in first grade and beyond. Controversy exists among eye care providers regarding whether moderately hyperopic children have adequate visual function without correction or whether correction provides benefit. Furthermore, the effect of correction is unclear, and further research is needed to determine whether hyperopic correction allows farsighted children to overcome deficits in near visual function, early literacy, reading, and attention.
Insulin-like growth factor-1 for the prevention or treatment of retinopathy of prematurity
Cochrane Database of Systematic Reviews · 2026-04-15
articleOpen accessRATIONALE: Retinopathy of prematurity (ROP) is a disorder of the developing retina in which abnormal proliferation of retinal blood vessels may lead to severe visual compromise or retinal detachment in infants born preterm. Insulin-like growth factor-1 (IGF-1) promotes normal retinal vessel growth in utero; however, IGF-1 levels fall substantially following preterm birth. By returning IGF-1 to in utero levels, postnatal treatment with IGF-1 may interrupt ROP pathogenesis, preventing disease or reducing its severity. OBJECTIVES: To compare treatment with IGF-1 to standard care or placebo for the prevention of retinopathy of prematurity or treatment of early retinopathy of prematurity. SEARCH METHODS: We used CENTRAL, MEDLINE, Embase, Cochrane Database of Systematic Reviews, Issue 3, 2025, in the Cochrane Library, CINAHL Plus with Full Text (EBSCOhost), Epistemonikos, clinical trials registries (US National Library of Medicine Clinicaltrials.gov, World Health Organization's International Trials Registry Platform, and ISRCTN Registry), together with reference checking and citation searching to identify studies that are included in this review. The latest search date was 10 March 2025. ELIGIBILITY CRITERIA: We considered all randomized controlled trials (RCTs), cluster-RCTs, and quasi-RCTs comparing IGF-1 with standard care or placebo for the prevention of ROP or treatment of early ROP in preterm infants. We planned to exclude cross-over randomized trials. OUTCOMES: Our outcomes of interest were: • Development of Type 1 ROP, defined as ROP requiring treatment at any time during the birth hospitalization or outpatient follow-up • Development of ROP ≥ stage 3 at any time during the birth hospitalization or outpatient follow-up • Development of ROP of any severity at any time during the birth hospitalization or outpatient follow-up • Occurrence of one or more serious adverse events (SAEs) at any time during the birth hospitalization • Mortality during the birth hospitalization • Hypoglycemia during the birth hospitalization RISK OF BIAS: We used the original Cochrane Risk of Bias 1 tool (RoB 1) to assess possible bias in the included studies. SYNTHESIS METHODS: Dichotomous data were reported using risk ratio (RR) and risk difference (RD) with 95% confidence intervals (CIs). Where possible, we synthesized results for each outcome using meta-analysis with fixed-effect models. We used GRADE to assess the certainty of evidence for each outcome. INCLUDED STUDIES: We included two studies totaling 140 participants. Both included studies were parallel-group RCTs performed between 2011 and 2016 enrolling extremely preterm infants in well-resourced settings in Europe and North America. The two published primary study references describe a two-center RCT (n = 19) and a 20-center RCT (n = 121) comparing treatment starting on the first day of life with intravenous IGF-1 (as mecasermin rinfabate) to standard care for prevention of ROP in newborn infants at 23 weeks' to 27 weeks plus six days' gestational age with follow-up through 40 weeks' postmenstrual age. SYNTHESIS OF RESULTS: = 0%; 2 RCTs, 140 infants; very low-certainty evidence). We assessed all results to be of very low certainty due to small total enrollment and substantial risk of bias. Both included studies had a high risk of bias in two domains. In addition, both were funded by industry. AUTHORS' CONCLUSIONS: The available data are of very low certainty, and so we are not able to draw conclusions about the effects of treatment with IGF-1 in preterm infants for preventing or treating ROP, or about its effects on risk of serious adverse events, mortality, or hypoglycemia in this population. FUNDING: This Cochrane review had no dedicated funding. REGISTRATION: Protocol available via DOI: 10.1002/14651858.CD013216.
V05-06 ROBOTIC RPLND WITH A DUPLICATE IVC: TECHNICAL CONSIDERATIONS
The Journal of Urology · 2025-04-08
article1st authorCorrespondingTranslational Vision Science & Technology · 2025-08-11 · 2 citations
articleOpen accessPurpose: To evaluate machine learning (ML) models for predicting treatment-requiring retinopathy of prematurity (TR-ROP) using image findings at 32 to 34 weeks of postmenstrual age, along with demographic and clinical characteristics. Methods: This secondary analysis included 771 infants with a birth weight of less than 1251 g who had at least one imaging session by 34 weeks postmenstrual age and at least one subsequent ROP examination for determining TR-ROP by ophthalmologists in the Telemedicine Approaches to Evaluating Acute-Phase Retinopathy of Prematurity (e-ROP) Study. Six ML models (K-nearest neighbors, support vector machine, random forest, extreme gradient boosting, deep neural network [DNN], and transformer) were evaluated for predicting TR-ROP. Prediction performance was evaluated using the area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, and specificity. Results: Using image findings and demographic and clinical data, ML models achieved AUCs ranging from 0.777 (K-nearest neighbors) to 0.853 (DNN), sensitivity ranging from 0.765 (extreme gradient boosting) to 0.929 (DNN), and specificity ranging from 0.644 (DNN) to 0.698 (transformer). Using image findings alone, the DNN performed best with an AUC of 0.787, sensitivity of 0.729, and specificity of 0.725. Conclusions: ML models using image findings, demographics and clinical characteristics moderately predict TR-ROP, with DNN achieving the highest AUC and sensitivity. Although ML models may provide tools for the early identification of high-risk infants for close monitoring and timely treatment of TR-ROP, future research is needed to improve their performance. Translational Relevance: ML has the potential to predict TR-ROP risk based on early image findings, demographics, and clinical characteristics.
Toxicology Letters · 2025-09-01
article1st authorCorrespondingThe Journal of Urology · 2025-04-09
editorialRetinopathy of prematurity: Still more to do
Indian Journal of Ophthalmology · 2025-10-28
articleOpen accessRetinopathy of prematurity (ROP) is a complex eye disorder in premature infants, requiring coordinated care between neonatologists and ophthalmologists. To prevent blindness, a fail-safe protocol for neonatal oxygen management, along with timely screening and treatment, must be established. Recently, there has been a rise in the prevalence of aggressive ROP (A-ROP), a severe disease type characterized by a featureless appearance to the retina, tortuous vessels, and minimal staging signs.[1] A-ROP resembles the findings in the first historical reports of retrolental fibroplasia[2] and may be found in settings where there is excessive use of 100% oxygen or poor monitoring of saturation levels. The natural history of ROP progresses through two distinct phases. Initial hyperoxia-driven vasoconstriction leads to cessation of retinal vessel growth, followed by pathological neovascularization in response to retinal hypoxia, producing the classical appearances of ROP. Although regression, or “die-back,” of previously formed vessels in the initial phase has been shown, it has only been documented in A-ROP among more mature preterm infants with severe disease [Fig. 1].[3] While classic ROP onset is predictable by postmenstrual age, A-ROP may have a compressed clinical course, demanding earlier and more frequent screening in more mature infants.Figure 1: Retinal images of a preterm child taken during telescreening in a semi-urban neonatal unit. Infant born at 32 weeks’ GA with 1700 g BW. (a) Right eye image taken at 2 weeks postnatal age showing blood vessels in posterior zone II (black arrows). (b) Same eye image taken at 4 weeks postnatal age showing regression (die-back) of these formed vessels from posterior zone II to zone I (black arrows). A large ischemic is seen in inferotemporal quadrant (white arrow) at 4 weeks postnatal age, which was absent 2 weeks earlier. (c and d) Left eye images of the same baby taken at a similar timeline showing die-back of formed vessels from zone II to zone I (black arrows). The infant had respiratory distress and was on continuous positive airway pressure for 5 days, followed by unblended high-flow oxygen for another 5 daysPrevention and neonatal care Preventing ROP begins with quality neonatal care. Antenatal corticosteroids for imminent preterm delivery (<35 weeks) and optimal delivery room management, e.g., delayed cord clamping and prevention of hypothermia, are vital. Oxygen, a critical drug in neonatal care, must be carefully regulated. The World Health Organization recommends a saturation target of 88%–94%, with alarms set at 86% and 95%.[4] In situations without air-oxygen blenders, simple blending methods using Y-connectors can provide safer oxygen delivery [Fig. 2]. Using a low-flow meter (with a maximum flow rate of 3 L/min and a minimum 0.1 or 0.25 L/min), inspired oxygen concentrations can be reduced by reducing the flow rate, but must be titrated using target oxygen saturations.Figure 2: Y-connector to blend oxygen and air from (a) cylinders and (b) central supplyAvoiding fluctuations in oxygenation is equally important and can be difficult when using continuous positive airway pressure; both caffeine therapy and kangaroo care can help stabilize oxygen levels. Adequate nutrition, including early parenteral support and mother’s milk, is essential for maintaining insulin-like growth factor levels and reducing ROP risk. Additional strategies include measures to prevent sepsis and careful antibiotic stewardship. Screening and programmatic needs Indian guidelines recommend ROP screening for infants <34 weeks’ gestation or <2000 g, and for selected older preterm infants needing respiratory support.[5] Screening should ideally start at 2–3 weeks postnatal age, given the faster progression seen in more mature babies. Delays in ophthalmologist availability, poor coordination with neonatology services, and lack of parental awareness can all hinder timely diagnosis and treatment. The appearance of A-ROP should prompt the ophthalmologist to provide feedback concerns about oxygen management to the neonatal team. Conclusion ROP-induced blindness is largely preventable with consistent implementation of oxygen protocols, enhanced screening coverage, and early intervention. With most forms of ROP progressing within a narrow age window, coordinated care between neonatologists and ophthalmologists remains the cornerstone of effective prevention and treatment.
Ophthalmology · 2024-05-23 · 14 citations
articleOpen accessPURPOSE: The International Classification of Retinopathy of Prematurity, Third Edition (ICROP3), acknowledged that plus-like retinopathy of prematurity (ROP) vascular changes occurs along a spectrum. Historically, clinician-experts demonstrate variable agreement for plus diagnosis. We developed a 9-photograph reference image set for grading plus-like changes and compared intergrader agreement of the set with standard grading with no plus, preplus, and plus disease. DESIGN: Retinal photographic grading and expert consensus opinion. PARTICIPANTS: The development set included 34 international ICROP3 committee members. The validation set included 30 ophthalmologists with ROP expertise (15 ICROP3 committee members and 15 non-ICROP3 members) METHODS: Nine ROP fundus images (P1 through P9) representing increasing degrees of zone I vascular tortuosity and dilation, based on the 34 ICROP3 committee members' gradings and consensus image reviews, were used to establish standard photographs for the plus (P) score. Study participants graded 150 fundus photographs 2 ways, separated by a 1-week washout period: (1) no plus, preplus, or plus disease and (2) choosing the closest P score image. MAIN OUTCOME MEASURES: Intergrader agreement measured by intraclass correlation coefficient. RESULTS: Intergrader agreement was higher using the P score (intraclass correlation coefficient, 0.75; 95% confidence interval, 0.71-0.79) than no plus, preplus, or plus disease (intraclass correlation coefficient, 0.67; 95% confidence interval, 0.62-0.72). Mean ± standard deviation P scores for images with mode gradings of no plus, preplus, and plus disease were 2.5 ± 0.7, 4.8 ± 0.8, and 7.4 ± 0.8, respectively. CONCLUSIONS: Intergrader agreement of plus-like vascular change in ROP using the P score is high. We now incorporate this 9-image reference set into ICROP3 for use in clinician daily practice alongside zone, stage, and plus assessment. P score is not yet meant to replace plus diagnosis for treatment decisions, but its use at our institutions has permitted better comparison between examinations for progression and regression, communication between examiners, and documentation of vascular change without fundus imaging. P score also could provide more detailed ROP classification for clinical trials, consistent with the spectrum of plus-like change that is now formally part of the International Classification of Retinopathy of Prematurity. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
Retinopathy of prematurity comes full circle
Archives of Disease in Childhood Fetal & Neonatal · 2024-04-11 · 3 citations
reviewOpen accessUrology · 2024-07-27
editorial
Recent grants
NIH · $13.6M · 2016
NIH · $643k · 2004
NIH · $1.2M · 1994
Frequent coauthors
- 369 shared
Gui‐Shuang Ying
University of Pennsylvania
- 188 shared
Gil Binenbaum
Children's Hospital of Philadelphia
- 123 shared
Maureen G. Maguire
Penn Presbyterian Medical Center
- 120 shared
David B. Schaffer
- 112 shared
Marjean Taylor Kulp
SUNY College of Optometry
- 96 shared
Agnieshka Baumritter
- 95 shared
Monte D. Mills
- 94 shared
Lynn Cyert
Northeastern State University
Education
MSCE, Biostatistics and Epidemiology
University of Pennsylvania
- 1999
MSCE, Perelman School of Medicine
University of Pennsylvania
- 1973
MD
Duke University School of Medicine
- 1969
BA
Duke University
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