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Published on: February 12, 2018
A controlled clinical trial of light and retinopathy of prematurity
V Seiberth1, O Linderkamp, M C Knorz
1University Eye Clinic, Klinikum Mannheim, Faculty for Clinical Medicine, University of Heidelberg, Germany.
Insights
Eye patching did not reduce retinopathy of prematurity in preterm infants. This study found no significant difference in the incidence or severity of retinopathy of prematurity between patched eyes and cycled lighting conditions.
Area of Science:
- Neonatal ophthalmology
- Perinatal medicine
Background:
- Bright light exposure is a suspected factor in retinopathy of prematurity development.
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
Purpose of the Study:
- To evaluate the efficacy of eye patching in reducing the incidence and severity of retinopathy of prematurity (ROP).
- To investigate the impact of light exposure on ROP pathogenesis in high-risk preterm infants.
Main Methods:
- A controlled clinical study involving 127 preterm infants (birth weight ≤ 1,500 g; gestational age ≤ 32 weeks).
- Infants' eyes were patched from birth to 35 weeks postconceptional age, compared to a control group with cycled lighting.
- Randomization was performed within specific birth weight strata.
Main Results:
- 42% of infants with patched eyes developed ROP (26/62), compared to 39% in the control group (25/65), with no statistically significant difference (P = .596).
- No significant differences in ROP incidence or severity were observed across birth-weight subgroups.
- Eye patching did not demonstrate a statistically significant benefit in preventing or reducing ROP.
Conclusions:
- Eye patching from birth to 35 weeks postconceptional age is not effective in decreasing the risk of retinopathy of prematurity in preterm infants.
- The study suggests that light exposure, while implicated, may not be the sole or primary modifiable factor for ROP prevention through patching.
- Further research is needed to explore alternative or adjunctive strategies for ROP prevention in vulnerable preterm populations.
Abstract:
Bright continuous light has been implicated in the pathogenesis of retinopathy of prematurity. To investigate the influence of light on the incidence and severity of retinopathy of prematurity, we enrolled 127 preterm infants (birth weight < or = 1,500 g; gestational age < or = 32 weeks) in a controlled clinical study. Randomization was done separately for three birth-weight groups (< 1,000 g; 1,000 to 1,249 g; 1,250 to 1,500 g). The babies' eyes were patched all day and night from birth to a gestational age of 35 weeks. The infants in the control group were exposed to cycled lighting conditions (that is, reduced light level during the night). Of 62 infants with patched eyes, 26 (42%) developed retinopathy of prematurity. In the control group, 25 of 65 infants (39%) showed retinopathy of prematurity (P = .596). There were also no statistically significant differences in the incidences of retinopathy of prematurity in the birth-weight subgroups or in the severity of retinopathy of prematurity. Thus, patching of the eyes from birth to 35 weeks of postconceptional age does not decrease the risk of retinopathy of prematurity in preterm infants when compared to a control group exposed to cycled lighting conditions.
