Related Experiment Video
Updated: Jun 5, 2026
Monitoring Dynamic Growth of Retinal Vessels in Oxygen-Induced Retinopathy Mouse Model
Published on: April 2, 2021
Exposure to persistent hemodynamically significant patent ductus arteriosus is associated with retinopathy of
Alison Ford1, Madeline Beauchene1, Amy H Stanford2
1University of Iowa Carver College of Medicine, Iowa City, Iowa.
Insights
Hemodynamically significant patent ductus arteriosus (hsPDA) increases risks for retinopathy of prematurity (ROP) in preterm infants. Shunt modulation may be a viable strategy to reduce ROP incidence in this vulnerable population.
Area of Science:
- Neonatalogy
- Ophthalmology
- Perinatal Medicine
Background:
- Patent ductus arteriosus (PDA) is common in preterm infants.
- Hemodynamically significant PDA (hsPDA) may increase ocular oxygen delivery.
- This can potentially predispose infants to retinopathy of prematurity (ROP).
Purpose of the Study:
- To investigate the association between hsPDA and ROP in preterm infants.
- To determine if hsPDA is an independent risk factor for ROP.
- To evaluate the predictive value of PDA shunt exposure for ROP severity.
Main Methods:
- Retrospective cohort study of infants born at <27 weeks gestation.
- Compared infants with hsPDA to controls.
- Assessed primary composite outcome of death or moderate-to-severe ROP, and secondary outcomes of ROP requiring treatment and any ROP.
Main Results:
- 86 infants included: 54 hsPDA, 32 controls.
- hsPDA group had higher rates of composite outcome and any ROP.
- hsPDA shunt exposure was independently associated with any ROP (P=0.006).
- PDA cumulative exposure score predicted moderate-to-severe ROP with 80% sensitivity and 78% specificity.
Conclusions:
- hsPDA is associated with increased risks of death or moderate-to-severe ROP in infants <27 weeks.
- hsPDA is also linked to higher rates of any ROP.
- Modulating PDA shunts could be a potential strategy to reduce ROP.
Background:
Hemodynamically significant patent ductus arteriosus (hsPDA) shunt may predispose infants to retinopathy of prematurity (ROP) because of its higher preductal cardiac output and blood oxygen content, which may augment ocular oxygen delivery.
Methods:
A retrospective cohort study of preterm infants, born at <27 weeks' gestation and admitted at <24h postnatal age to a large quaternary referral was conducted. The primary composite outcome was death at <32 weeks or moderate-to-severe ROP (≥stage 2 or requiring treatment) in either eye. Secondary outcomes included ROP requiring treatment, and any ROP. Univariate analysis of patient characteristics and outcomes was performed as well as logistic regression. A receiver operating characteristics curve was generated for the outcome of ROP ≥stage 2 or requiring treatment.
Results:
A total of 91 patients were screened, of whom 86 (54 hsPDA, 32 controls) were eligible for inclusion. hsPDA patients were younger and lighter at birth and had a higher burden of hyperglycemia and respiratory illness. The rates of the composite outcome (death <32 weeks or moderate-to-severe ROP) and of any ROP were more frequent in the hsPDA group. hsPDA shunt exposure was independently associated with development of any ROP among survivors to assessment (P = 0.006). PDA cumulative exposure score of 78 (clinical equivalent = 7 days high-volume shunt exposure) predicts moderate-to-severe ROP with 80% sensitivity and 78% specificity.
Conclusions:
Among infants <27 weeks, hsPDA shunt is associated with increased risks of a composite outcome of death or moderate-to-severe ROP, as well as ROP of any stage. Shunt modulation as a strategy to reduce ROP represents a biologically plausible avenue for investigation.
