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PH Hong, KW Wright, S Fillafer, A Sola, LC Chow; Strict Oxygen Management is Associated with Decreased Incidence of Severe of Retinopathy of Prematurity . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4011.
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Purpose: To determine whether strict curtailment of oxygen in the neonatal intensive care unit (NICU) is associated with decreased levels of severe retinopathy of prematurity (ROP). Methods: This was a retrospective longitudinal study of the incidence of severe ROP in infants <1501g birthweight before and after implementation in April 1998 of a new clinical practice of oxygen management in a large level III NICU. Data was collected in real time in a local database. A separate phase of the study included a retrospective chart review of the incidence of myopia and strabismus in infants <1251g birthweight who underwent strict oxygen monitoring. Results: The incidence of stage III-IV ROP significantly decreased from 12.0% in 1997 (n=217) to 2.3% in 2000 (n=260) (p<0.01). The need for ROP laser treatment decreased from 4.6% in 1997 to 0% from 1999-2000 (p<0.01). The incidence of stage III-IV ROP and ROP laser as reported by the Vermont Oxford Network had not changed significantly over the same time period. The prevalence of -0.25 D or greater myopia was 7.5% (6/80) in eyes with 3-12 months post-term follow-up and 25.8% (16/62) in eyes with 1-3 years post-term follow-up. The prevalence of strabismus was 10.0% (4/40) in patients with 3-12 months post-term follow-up and 19.4% (6/31) in patients with 1-3 years post-term follow-up. Conclusion: Severe ROP in very low birthweight infants has decreased significantly in association with the implementation of a strict bedside practice of oxygen management. The prevalence of myopia and strabismus in our study group was similar to previous reports for very low birthweight infants at other centers. CR: None. Support: The Discovery Fund for Eye Research, The Henry L. Guenther Foundation, The Pfeiffer Foundation, Ruth and Harry Roman Chair in Neonatology - Cedars-Sinai Medical Center
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