The effect of erythropoietin on the severity of retinopathy of prematurity.
OBJECTIVE
Exogenous human erythropoietin (EPO) artificially synthesised through recombinant DNA technology (rHuEPO) is currently used as a substitute for blood transfusion in preterm and low birth weight neonates. The objective of this study is to determine whether the use of rHuEPO is associated with an increased severity of retinopathy of prematurity (ROP) in preterm neonates.


METHODS
This retrospective review studies neonates who were admitted to a tertiary perinatal unit and screened for ROP during the 10-year period from January 2003 to December 2012.


RESULTS
: During the 10-year period, 688 preterm neonates underwent ROP screening, with 198 identified as having ROP. The incidence of stage 1 ROP was 51.5% (102/198), followed by 35.9% (71/198) for stage 2, and 12.6% (25/198) for stage 3 and greater. Plus disease was seen in 14 neonates (7.1%). Treatment (laser photocoagulation) was administered in 64% of neonates (16/25) with stage 3 of the disease and above because of progression to threshold ROP. Twenty-six (13%) of the neonates received rHuEPO treatment. There were no statistically significant differences in birth weight (910.4 vs 885 g; P=0.71), gestational age (26.5 vs 25.8 weeks; P=0.09), and duration of ventilation (512 vs 501.4 h; P=0.92) between neonates who did not receive rHuEPO compared with those who were treated with rHuEPO. Multivariate regression analysis showed that the use of EPO was associated with increased severity of ROP.


CONCLUSIONS
EPO therapy appears to increase the risk of development and worsening of ROP.
1] Department of Neonatology, The Townsville Hospital, Douglas, Queensland, Australia [2] Mothers and Babies Research Centre, Hunter Medical Research Institute, John Hunter Hospital, Locked Bag 1, Hunter Region Mail Centre, Newcastle, New South Wales, Australia.
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Kandasamy
Department of Neonatology, The Townsville Hospital, Douglas, Queensland, Australia.
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Kumar
Department of Optometry and Vision Science, The University of Melbourne, Melbourne, Victoria, Australia.
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Hartley
D000751:Anemia, Neonatal / Q000517:prevention & control; D001724:Birth Weight; D000068817:Epoetin Alfa; D004921:Erythropoietin / Q000009:adverse effects*; D005260:Female; D005865:Gestational Age; D006397:Hematinics / Q000009:adverse effects*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D017075:Laser Coagulation; D008297:Male; D011994:Recombinant Proteins / Q000009:adverse effects; D012178:Retinopathy of Prematurity / Q000139:chemically induced* / Q000503:physiopathology / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index
D006397:Hematinics; D011994:Recombinant Proteins; D004921:Erythropoietin; D000068817:Epoetin Alfa