Onset of retinopathy of prematurity as related to postnatal and postconceptional age
Related Experiment Videos
Insights
Vitamin E supplementation delayed the onset of retinopathy of prematurity (ROP) in premature infants. Both the timing of birth and the infant's retinal development stage influence ROP onset.
Area of Science:
- Ophthalmology
- Neonatology
- Perinatal Medicine
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- The exact timing of ROP onset is influenced by multiple factors, including perinatal events and retinal maturity.
Purpose of the Study:
- To investigate the roles of perinatal events and retinal developmental stage in determining the age of ROP onset.
- To evaluate the effect of prophylactic vitamin E on ROP onset timing.
Main Methods:
- A randomized clinical trial involving 914 premature infants comparing placebo and vitamin E treatment.
- Analysis of gestational age at birth, postnatal age, and postconceptional age at ROP diagnosis (using International Classification of Retinopathy of Prematurity - ICROP).
Main Results:
- The mean postnatal age of ROP onset was significantly delayed by 1.4 weeks in vitamin E treated infants compared to placebo.
- Both postnatal and postconceptional ages at ROP onset correlated with gestational age at birth in both treatment groups.
Conclusions:
- Prophylactic vitamin E can delay the onset of retinopathy of prematurity.
- Both the event of premature birth and the extent of retinal development are critical determinants for the timing of ROP onset.
Abstract:
The hypothesis that both perinatal events and stage of retinal development are important factors in determining the age at onset of retinopathy of prematurity (ROP) was tested by comparing gestational age at birth with postnatal and postconceptional age when ROP (using ICROP) was first seen. The study population consisted of 207 infants (111 placebo (P) treated, 96 vitamin E (E) treated) who developed ROP among a group of 914 premature infants (460 P, 454 E) enrolled in a randomised clinical trial of the effect of prophylactic use of vitamin E at pharmacological serum levels on incidence and severity of retinopathy. The mean postnatal age at onset of retinopathy was delayed in E treated infants compared with P treated infants by 1.4 weeks (t = 4.004, p < 0.0001). For both P and E treated infants postnatal age at onset of ROP (which reflects the state of retinal development at which birth insults occur) and postconceptional age at onset of ROP which defines state of maturity) were correlated with gestational age at birth. This suggests that both the event of premature birth and the extent of retinal development are important in determining when ROP will first be observed.