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Surfactant replacement therapy and the prevalence of acute retinopathy of prematurity
T R Tubman1, S J Rankin, H L Halliday
1Neonatal Intensive Care Unit, Royal Maternity Hospital, Belfast, UK.
Insights
Porcine surfactant (Curosurf) treatment for premature infants with respiratory distress syndrome did not increase the risk of retinopathy of prematurity (ROP). The ROP prevalence in treated infants was similar to historical data for untreated very-low-birthweight infants.
Area of Science:
- Neonatology
- Ophthalmology
- Pulmonology
Background:
- Respiratory distress syndrome (RDS) is a common condition in preterm infants.
- Surfactant replacement therapy is a standard treatment for RDS.
- Retinopathy of prematurity (ROP) is a potentially blinding condition affecting preterm infants.
Purpose of the Study:
- To investigate the association between porcine surfactant (Curosurf) treatment and the incidence of retinopathy of prematurity (ROP).
- To assess the risk of acute ROP in very-low-birthweight infants receiving Curosurf.
Main Methods:
- A cohort of 76 preterm infants treated with Curosurf for severe RDS between 1985 and 1990 was studied.
- Infants underwent regular ophthalmoscopic examinations from 32 weeks post-menstrual age until hospital discharge.
- ROP findings were graded using the International Classification of ROP.
Main Results:
- Of 76 infants, 62 survived to discharge. Of 49 examined infants, 14 (29%) developed acute ROP (stages I-IV).
- One infant required cryotherapy for ROP.
- No infants with a birthweight >1,500 g developed ROP.
- The overall ROP prevalence was comparable to non-surfactant-treated very-low-birthweight infants.
Conclusions:
- Porcine surfactant (Curosurf) treatment is not associated with an increased risk of acute retinopathy of prematurity in surviving very-low-birthweight infants.
- The findings suggest that Curosurf is safe concerning ROP development.
Abstract:
To determine if surfactant replacement treatment is associated with an increase in the prevalence of retinopathy of prematurity (ROP) we studied 76 preterm babies who were treated with porcine surfactant (Curosurf) for severe respiratory distress syndrome from 1985 to 1990. Babies were first examined by indirect ophthalmoscopy at the equivalent of 32 weeks post-menstrual age and subsequently at 2-week intervals until discharge from hospital. Findings were documented according to the International Classification of ROP. Sixty-two (82%) babies survived to discharge, 7 survivors were not examined due to transfer elsewhere. Acute ROP developed in 14 (29%) of the 49 babies examined (7 stage I, 4 stage II, 2 stage III, and 1 stage IV); one baby required cryotherapy. No baby of birthweight greater than 1,500 g developed ROP. The prevalence of ROP was similar to that reported for non-surfactant-treated very-low-birthweight babies. We conclude that Curosurf treatment does not increase the risk of acute ROP in surviving very-low-birthweight babies.