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Tiffany Sara Liu, Matthew Bizzaro, Richard Ehrenkranz, Kathleen Stoessel; Retrospective analysis on the prevalence of Severe Retinopathy of Prematurity with a Change in Oxygen Supplementation at Yale New-Haven Hospital. Invest. Ophthalmol. Vis. Sci. 2016;57(12):6280.
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Retinopathy of Prematurity (ROP), a disease of underdeveloped retinal vasculature in premature infants, was previously treated with high oxygen saturation limits until studies have shown this may shut down normal vascular development by down-regulating an essential vascular endothelial growth factor. Recent studies have shown using lower oxygen saturation targets closer to in utero for the first weeks of life and then liberalizing the oxygen saturation lessened the incidence of severe ROP requiring laser photocoagulation intervention. In this retrospective study we evaluate the incidence of severe ROP requiring laser intervention before and after a change in oxygen saturation from initial higher rates to lower saturation rates at the Yale New-Haven Neonatal ICU.
Charts of premature infants (n=679) <=1500 grams birth weight and/or <=30 weeks gestational age born at Yale-New Haven Children’s Hospital or transferred in within the first 48 hours of life that were screened for ROP between the dates of 1/1/2009 and 12/31/2014 were reviewed. Zone and stage of ROP, progression of ROP, timing of progression of ROP, and need for laser surgery were recorded. Results were analyzed using repeated measures analysis of variance.
Of 679 premature infants screened for ROP from 2009-2014, 27 had severe ROP requiring laser (7.3%). Prior to changing to lower initial oxygen saturation rates, of the 369 infants examined, 22 infants required laser (6.0%). After changing to lower oxygen saturation rates, of the 310 infants examined, 5 infants required laser (1.6%). This demonstrated a statistically significant decrease in the incidence of severe ROP requiring laser after oxygen saturation change (OR=3.87; CI=1.45-10.34; p=0.0039).
Our results demonstrate lower initial oxygen saturation rates in treatment of premature infants leads to a statistically significant decrease in the incidence of severe ROP requiring laser. Further analysis of the severity of ROP for premature infants including zone and stage before and after oxygen saturation change, as well as associated factors such as birth weight and gestational age, and comorbidities will need to be further explored to better elucidate the impact of the change in oxygen.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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