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Supplemental oxygen may decrease progression of prethreshold disease to threshold retinopathy of prematurity

M W Gaynon1, D K Stevenson, P Sunshine

  • 1Department of Ophthalmology, Stanford University, Calif., USA.

Journal of Perinatology : Official Journal of the California Perinatal Association
|February 3, 1998
PubMed
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Higher oxygen saturation levels in premature infants with retinopathy of prematurity (ROP) correlated with a decreased rate of disease progression. This suggests a potential benefit of increased oxygenation in managing ROP.

Area of Science:

  • Ophthalmology
  • Neonatology
  • Perinatal Medicine

Background:

  • The optimal oxygen saturation for premature infants with prethreshold retinopathy of prematurity (ROP) remains undetermined.
  • Historical data shows stepwise increases in target oxygen saturation levels over time.

Purpose of the Study:

  • To investigate the relationship between varying oxygen saturation levels and the progression rate of prethreshold ROP.
  • To evaluate the impact of different oxygen saturation targets on the conversion of prethreshold ROP to threshold ROP.

Main Methods:

  • Retrospective analysis of 153 infants with prethreshold ROP at Stanford University (1985-1993).
  • Review of 26 infants (1994-1996) excluded from the STOP-ROP study.
  • Tabulation of infant characteristics and calculation of ROP progression rates.

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Main Results:

  • Progression rates to threshold ROP were stable (average 37%) from 1985-1989.
  • A significant drop in progression to 7% was observed between 1990-1993 when target saturation increased to 99%.
  • Progression rates increased to 38% from 1994-1996.

Conclusions:

  • Targeting higher oxygen saturation (99%) in infants with prethreshold ROP was associated with a decreased rate of progression.
  • Moderate supplemental oxygen did not appear to arrest retinal vascular maturation.
  • Further research is warranted to establish definitive oxygenation guidelines for ROP management.