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Refractive Outcome in Preterm Newborns With ROP After Propranolol Treatment. A Retrospective Observational Cohort
Luca Filippi1, Giacomo Cavallaro2, Lavinia Perciasepe1
1Neonatal Intensive Care Unit, Medical Surgical Fetal-Neonatal Department, "A. Meyer" University Children's Hospital, Florence, Italy.
Insights
Propranolol treatment did not alter physical development or refractive outcomes in infants with retinopathy of prematurity (ROP) at one year corrected age. Further trials are needed to confirm if propranolol can indirectly improve vision by slowing ROP progression.
Area of Science:
- Ophthalmology
- Neonatology
- Pharmacology
Background:
- Explorative studies suggest propranolol may reduce retinopathy of prematurity (ROP) progression.
- Short-term effects of propranolol on ROP at one year corrected age require further evaluation.
- Understanding propranolol's impact on infant development and vision is crucial.
Purpose of the Study:
- To assess the physical development and refractive outcomes in infants with prior ROP treated with propranolol.
- To compare infants treated with propranolol to a control group without propranolol therapy.
- To evaluate the short-term effects of propranolol on ROP progression and visual outcomes.
Main Methods:
- Multi-center retrospective observational cohort study.
- Compared 49 infants treated with propranolol to 49 control infants with similar ROP stages and anthropometrics.
- Assessed physical development (weight, length, head circumference) and refractive outcomes at one year corrected age.
Main Results:
- No statistically significant differences in weight, length, or head circumference between propranolol-treated and control groups.
- Spherical equivalent values decreased with ROP progression, correlating with increased severe myopia.
- Propranolol treatment did not show any difference in refractive outcomes compared to the control group.
Conclusions:
- ROP progression is linked to increased refractive errors and myopia.
- Propranolol treatment itself does not appear to affect refractive outcomes in infants with ROP.
- Propranolol may indirectly improve visual outcomes by mitigating ROP progression, pending further clinical trial confirmation.
Abstract:
Background: Recent explorative studies suggest that propranolol reduces retinopathy of prematurity (ROP) progression, but the short-term effects of propranolol treatment at 1 year of corrected age have not been extensively evaluated. Methods: A multi-center retrospective observational cohort study was conducted to assess the physical development and the refractive outcome of infants with prior ROP treated with propranolol. Forty-nine infants treated with propranolol were compared with an equal number of patients who did not receive any propranolol therapy and represent the control group, with comparable anthropometrical characteristics and stages of ROP. Results: The weight, length, and head circumference at 1 year of corrected age were similar between infants who had been treated, or not, with propranolol, without any statistically significant differences. Refractive evaluation at 1 year showed spherical equivalent values decreasing with the progression of ROP toward more severe stages of the disease, together with an increasing number of infants with severe myopia. On the contrary, no differences were observed between infants who had been treated with propranolol and those who had not. Conclusion: This study confirms that the progression of ROP induces an increase of refractive errors and suggests that propranolol itself does not affect the refractive outcome. Therefore, if the efficacy of propranolol in counteracting ROP progression is confirmed by further clinical trials, the conclusion will be that propranolol might indirectly improve the visual outcome, reducing the progression of ROP.