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Controlled trial of D-penicillamine to prevent retinopathy of prematurity
Insights
D-penicillamine (DPA) effectively prevents retinopathy of prematurity (ROP) in very low-birth-weight infants. This study found no serious adverse effects of DPA during the neonatal period, suggesting a promising preventative strategy.
Area of Science:
- Neonatology
- Ophthalmology
- Pharmacology
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Very low-birth-weight infants are at high risk for developing ROP.
- Current preventative strategies for ROP have limitations.
Purpose of the Study:
- To evaluate the effectiveness of D-penicillamine (DPA) in preventing ROP.
- To assess the safety profile of DPA in premature infants.
Main Methods:
- A prospective controlled trial involving 204 infants (birthweight 751-2000g, gestational age 26-35 weeks).
- Infants were randomized into DPA-treated (100) and control (104) groups.
- Blinded assessment by ophthalmologists evaluated ROP severity in surviving infants.
Main Results:
- None of the 71 surviving DPA-treated infants developed ROP stage II or graver.
- Six of the 70 surviving control infants developed ROP stage II or graver.
- No serious adverse effects of DPA were observed during the neonatal period.
Conclusions:
- D-penicillamine (DPA) shows significant potential in preventing retinopathy of prematurity (ROP).
- DPA appears to be a safe therapeutic option for very low-birth-weight infants at risk for ROP.
- Further research may support DPA as a standard preventative treatment for ROP.
Abstract:
204 infants with birthweights between 751 and 2000 g and 26-35 weeks gestational age (100 treated and 104 control subjects) were enrolled in a prospective controlled trial of the effectiveness of D-penicillamine (DPA) in the prevention of retinopathy of prematurity (ROP). The two groups did not differ significantly in gestational age, birth weight, Apgar scores, the time of exposure to oxygen and in the incidence of PDA or in the number of exchange transfusions and RBTs. Of the treated infants 29, and of the control infants 34 died before the tenth week of life. These cases were not included in further analysis. Patients were subsequently examined and assessed by two ophthalmologists independently, who did not know which babies were receiving DPA. Six of the 70 surviving control infants and none of the 71 surviving treated infants had ROP stage II or graver. The results suggested that ROP may effectively be prevented with DPA in very low-birth-weight-infants, and that the drug has no serious adverse effects during the neonatal period.