Purchase this article with an account.
Jonathan E Sears, Christine Sonnie, George Hoppe; Incidence of ROP After SUPPORT. Invest. Ophthalmol. Vis. Sci. 2016;57(12):6287.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Recent clinical trials (SUPPORT) investigating the use of reduced oxygen saturations in premature infants demonstrated reduced retinopathy but increased mortality. This study investigated the difference in incidence of ROP using the new SUPPORT saturation targets in comparison to a previously published oxygen protocol used at one NICU. The data was compiled from this NICU in which the previous standards were developed.
This is a retrospective, non-interventional, study 20 months prior and 20 months after oxygen saturation ranges were changed from initial standards (85-92% age less than 34 weeks corrected gestational age (CGA) and >95% > 34 weeks CGA) to the standards established by the SUPPORT (constant 90-95% from birth to discharge). Age at birth, birth weight, multiple births, total exams, Zone and Stage of ROP were compared between these two time periods.
Mean gestational at birth between the two cohorts was 27.9 pre and 28.3 post oxygen saturation change. Mean birth weight was 1000g pre and 1040g post O2 saturation change. Multiple births were 14 pre and 13 post O2. ROP increased under the new oxygen protocol by greater than 3-fold (any ROP 13% pre and 40% post/p = .001). Five children had Type 1 ROP under the SUPPORT recommendations, whereas there were two children that required treatment under the old saturation protocol. There were no retinal detachments in either group. Mortality was unchanged at less than 11% in both cohorts.
The new oxygen protocol created more overall ROP. There was no incidence of unfavorable outcome with respect to ROP, but the number of children who reached Type I disease under the new protocol doubled. The unit studied here comprises 1/4 of all NICU beds serviced by the Cole Eye Institute and has larger gestational birthweight and gestational age at birth infants when compared to the main campus NICU and Metro hospital NICU. A change in oxygen saturations from biphasic targets to the SUPPORT recomendations increased the incidence of ROP, even in this homogeneous group of infants in a relatively low risk population.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
This PDF is available to Subscribers Only