April 2009
Volume 50, Issue 13
ARVO Annual Meeting Abstract  |   April 2009
Does Antifungal Prophylaxis Affect the Incidence and Severity of Retinopathy of Prematurity in Extremely Low Birth Weight Infants?
Author Affiliations & Notes
  • K. B. Wise
    Vanderbilt Eye Institute, Nashville, Tennessee
  • J.-H. Weitkamp
    Vanderbilt University Medical Center, Nashville, Tennessee
  • F. M. Recchia
    Vanderbilt Eye Institute, Nashville, Tennessee
  • Footnotes
    Commercial Relationships  K.B. Wise, None; J.-H. Weitkamp, None; F.M. Recchia, None.
  • Footnotes
    Support  None.
Investigative Ophthalmology & Visual Science April 2009, Vol.50, 3153. doi:
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      K. B. Wise, J.-H. Weitkamp, F. M. Recchia; Does Antifungal Prophylaxis Affect the Incidence and Severity of Retinopathy of Prematurity in Extremely Low Birth Weight Infants?. Invest. Ophthalmol. Vis. Sci. 2009;50(13):3153.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose: : Candidemia has been suggested as a risk factor for development of threshold retinopathy of prematurity (ROP). Antifungal prophylaxis for highest-risk preterm infants has been shown to limit drug exposure without missing preventable cases of invasive fungal infection. As this practice may become more common, we investigated whether prophylactic use of fluconazole was associated with incidence or severity of ROP.

Methods: : Retrospective cohort study. Records of consecutive infants hospitalized between 11/05 and 10/06 with birth age of <26 wks gestation and/or birth weight of <750 g who received fluconazole prophylaxis (cases) and records of consecutive infants with similar birth history from the preceding 12-month period (controls) were compared. Primary outcome measures were: (1) incidence of any ROP; (2) highest stage of ROP; (3) need for laser. Secondary outcome measures were: (1) age at development of highest stage of ROP; and (2) age at conclusion of acute retinal screening.

Results: : 42 infants received prophylaxis, and 44 did not, of whom 31 and 36 infants, respectively, survived. While there was no difference in birth weight, birth age, or gender at baseline between these two groups, mean birth weight of survivors in the group receiving prophylaxis was significantly lower (657 g vs. 731 g, p = 0.0062). The incidences of any ROP (80.7% vs. 80.6%, p = 0.99) and need for laser (38.7% vs. 27.8%, p = 0.49) were similar between groups. An ordinal regression model demonstrated no association between ROP stage and prophylaxis (p = 0.83). Mean post-conceptional age at highest stage of ROP (37.1 wks vs. 37.5 wks) and at the conclusion of acute retinal screening (43.1 wks vs. 43.8 wks) were similar between groups. To control for a possible effect of the lower birth weight among the infants receiving prophylaxis, we conducted a logistic regression analysis, which demonstrated no effect of birth weight on any outcome measures.

Keywords: retinopathy of prematurity • fungal disease • retina 

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