Retinopathy of prematurity in very low birth weight infants and the potential protective role of indomethacin.
OBJECTIVE
To describe clinical features of very low birth weight (VLBW) infants and examine the effect of indomethacin on the incidence of retinopathy of prematurity (ROP).


METHODS
Medical records of all VLBW infants over a 4-year period were reviewed. Data regarding systemic and ophthalmic examinations were analyzed.


RESULTS
Forty-seven infants with ROP were evaluated. Most infants had bilateral stage 1 or 2 disease extending 5 clock hours. Infants with ROP had younger mean gestational age, had lower gestational weight, and demonstrated higher incidence of diseases of prematurity. These infants were exposed to increased doses of surfactant and higher oxygen concentration for a prolonged duration given their immature pulmonary status. Independent predictors of ROP susceptibility also included length of hospitalization and Apgar score at 5 minutes. Patent ductus arteriosus was more common among infants with ROP. Approximately half of the infants who received one or two doses of indomethacin had ROP, but the ROP rate was decreased in infants who received three doses.


CONCLUSIONS
Premature infants with younger gestational age, lower gestational weight, and severe morbidities were found to have an increased prevalence of ROP. Indomethacin treatment for patent ductus arteriosus may have a protective role in the development of severe ROP.
Department of Pediatrics B, Sheba Medical Center, Tel Hashomer, Israel.
Ran D
RD
Goldman
Abraham
A
Spierer
Alexander
A
Zhurkovsky
Jacob
J
Kwint
Monica
M
Schwarcz
Guy J
GJ
Ben Simon
D016861:Cyclooxygenase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007213:Indomethacin / Q000008:administration & dosage / Q000627:therapeutic use*; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D008297:Male; D012178:Retinopathy of Prematurity / Q000175:diagnosis / Q000517:prevention & control*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
D016861:Cyclooxygenase Inhibitors; D007213:Indomethacin