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Updated: Jan 31, 2026
Oxygen-Induced Retinopathy Model for Ischemic Retinal Diseases in Rodents
Published on: September 16, 2020
Reduced rate of treated retinopathy of prematurity after implementing lower oxygen saturation targets
Fanny Söderström1, Erik Normann2, Gerd Holmström3
1Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden. fanny.soderstrom@kbh.uu.se.
Insights
Lowering oxygen saturation targets in extremely premature infants halved the incidence of treatment-requiring retinopathy of prematurity (ROP). The most immature infants showed the greatest benefit, though a link to necrotizing enterocolitis requires further investigation.
Area of Science:
- Neonatalogy
- Pediatric Ophthalmology
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Oxygen saturation targets have been debated for extremely preterm infants to balance ROP prevention and other morbidities.
Purpose of the Study:
- To evaluate the impact of lower oxygen saturation targets on the incidence of ROP in extremely premature infants.
- To assess the safety and efficacy of implementing new oxygenation guidelines.
Main Methods:
- Retrospective cohort study of 325 infants born between 22-25 weeks gestation (2005-2015).
- Comparison of high (87-93%) versus low (85-90%) oxygen saturation targets.
- Exclusion of early transferred infants to minimize bias in main analysis.
Main Results:
- Treatment-requiring ROP incidence was significantly lower in the low saturation group (14% vs 28%, p<0.05).
- The most immature infants demonstrated the most significant reduction in ROP.
- Necrotizing enterocolitis was more frequent in the low saturation group (21% vs 10%, p<0.05).
- Overall survival rates showed a trend towards lower survival in the low saturation group (69% vs 76%, p=0.17).
Conclusions:
- Implementing lower oxygen saturation targets effectively reduced treatment-requiring ROP in extremely premature infants.
- The benefits for ROP were most pronounced in the most immature infants.
- A potential association between lower oxygenation and increased necrotizing enterocolitis warrants further study.
Objective:
To evaluate an implementation of lower oxygen saturation targets with retinopathy of prematurity (ROP) as primary outcome, in infants at the lowest extreme of prematurity.
Study Design:
Retrospective cohort including infants born at 22-25 weeks of gestation in 2005-2015 (n = 325), comparing high (87-93%) and low (85-90%) targets; infants transferred early were excluded from the main analysis to avoid bias.
Results:
Overall survival was 76% in high saturation era, and 69% in low saturation era (p = .17). Treatment-requiring ROP was less common in low saturation group (14% vs 28%, p < .05) with the most prominent difference in the most immature infants. Including deceased infants in the analysis, necrotizing enterocolitis was more frequent in low saturation era (21% vs 10%, p < .05).
Conclusions:
Implementing lower saturation targets resulted in a halved incidence of treatment-requiring ROP; the most immature infants seem to benefit the most. An association between lower oxygenation and necrotizing enterocolitis cannot be excluded.
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