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M.S. Neimeyer, E. Fayard, T. Liu, J. Dunbar; RECOMBINANT HUMAN ERYTHROPOIETIN (rhEPO) TREATMENT AND INCIDENCE OF RETINOPATHY OF PREMATURITY (ROP) . Invest. Ophthalmol. Vis. Sci. 2004;45(13):4025.
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© ARVO (1962-2015); The Authors (2016-present)
ABSTRACT Purpose: To see if there is any correlation between treatment with recombinant human erythropoietin (rhEPO) in a population at risk for retinopathy of prematurity (ROP) and an increased ROP incidence and/or severity. Methods: We retrospectively reviewed complete medical records for 264 infants with birth weight ≤ 1500g, 119 born in 1994 (non–erythropoietin group) and 145 in 2002 (erythropoietin group). The records of both groups were analyzed for demographic data (birth weight, gestational age, gender, inborn/outborn status), incidence of major morbidity (bronchopulmonary dysplasia, days of mechanical ventilation, patent ductus arteriosus, necrotizing enterocolitis, intraventricular hemorrhage and number of blood transfusions), and rhEPO treatment. The outcome measures were incidence of ROP (any stage) and severity of ROP (threshold ROP/photocoagulation treatment). Results: The erythropoietin group with 145 infants had 128 (88%) receiving rhEPO. The non–erythropoietin group with 119 infants had only 4 (3.4%) receiving rhEPO. To avoid a selection bias, we included data for the few infants that received EPO in the non–EPO group (n=4) and the infants that did not receive it in the EPO group (n=17). When those infants were excluded from the analysis, the statistical results did not change. Both groups were comparable as far as demographic data and incidence of major morbidity. The EPO group had a significantly higher incidence of ROP than the non–EPO group, 59.3% vs. 42.9% (p=0.008). Threshold ROP was also higher, 26.9% vs. 13.4% (p=0.007), in the EPO cohort. Infants with ROP in the EPO group received significantly more rhEPO than those without ROP (25.6 doses vs. 17.5, p=0.000). Conclusions: There is a positive correlation between rhEPO treatment and the incidence and severity of ROP in premature infants. A prospective study should be done to further elucidate the causal relationship between rhEPO and ROP.
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