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Faizah N Bhatti, Gil Binenbaum, Lauren Tomlinson, Yinxi Yu, Gui-Shuang Ying; Retinopathy of Prematurity in Infants with Cardiovascular Disease. Invest. Ophthalmol. Vis. Sci. 2020;61(7):2780.
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© ARVO (1962-2015); The Authors (2016-present)
Reports suggest that infants with congenital heart disease may be at increased risk of severe retinopathy of prematurity (ROP). We sought to determine the association of cardiovascular disease (CD) with the development of ROP in a large cohort of premature infants at risk for ROP.
We performed secondary analyses of data from the Postnatal Growth and ROP Validation Study (G-ROP-2), a prospective observational cohort of infants undergoing ROP examinations at 41 hospitals during 2015-2017). CD was categorized based upon pulmonary blood flow (PBF), systemic blood flow (SBF), and dysrhythmia. Primary outcomes included associations between CD and ROP or severe ROP, adjusted for birth weight and gestational age using multivariable logistic regression.
Among 3,980 infants, 538 (13.5%) had CD (49 pulmonary hypertension, 304 increased PBF, 107 decreased PBF, 22 decreased SBF, 14 dysrhythmia, 42 other); 1,643 (40.4%) developed ROP; and 503 (12.6%) developed severe (Type 1 or 2) ROP. Infants with pulmonary hypertension, changes in PBF and SBF had more days on supplemental oxygen in the first month of life (66%-88%) than infants without CD (52%). Increased PBF was associated with a higher risk of ROP (aOR=1.47, 95% CI 1.09-1.99, p=0.01), but other categories of CD were not. In contrast, pulmonary hypertension was associated with a higher risk of severe ROP (OR=2.35, 95% CI: 1.19-4.64, p=0.01), but other categories of CD were not. Onset of ROP and severe ROP did not vary with presence or absence of CD.
Preterm infants with pulmonary hypertension were more likely to develop severe ROP, but not infants with other types of CD. High proportion of days on supplemental oxygen in the first month of life may be a contributing factor but venous congestion could cause retinal vascular changes simulating plus disease, which could not be distinguished from true plus disease using these data. Further study is needed to evaluate these findings.
This is a 2020 ARVO Annual Meeting abstract.
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