Abstract
Purpose :
The purpose of this study was to identify factors that influence the timing and duration of retinopathy of prematurity (ROP) regression, a variable process in preterm infants. We hypothesize that more inflammatory exposures and slower growth before a corrected gestational age (CGA) of 36 weeks delay and prolong ROP regression.
Methods :
This retrospective chart review included infants born ≤ 30 weeks CGA and < 1500 grams previously included in three prospective cohort studies. Baseline characteristics, growth rates, and inflammatory events were collected for 76 infants who developed ROP not requiring treatment. The outcomes of interest were gestational age (GA) at the most severe stage of ROP (GA MSROP), GA at which ROP regression began, GA at the time of complete vascularization (GA CV), and duration of ROP regression. Continuous variables were analyzed with Pearson’s correlation coefficients and categorical variables were analyzed with t-tests or analysis of variance (P<0.05).
Results :
Mean GA was 35.3 weeks at MSROP, 40.0 weeks at time that ROP regression began, and 49.8 weeks at time of CV. Mean duration of ROP regression was 9.5 weeks. As summarized in Tables 1 and 2, later GA MSROP was associated with slower head growth, increased number of positive cultures, increased platelet transfusion volume in the first week of life, increased red blood cell transfusion volume, greater severity of ROP, and iron deficiency (ferritin<40). Later GA CV and prolonged duration of ROP regression were associated with slower length gain, increased number of positive cultures, higher mean total insulin dose in the first week of life, higher total number of inflammatory events, greater severity of ROP, maternal chorioamnionitis, and chronic lung disease (CLD). Increased IL-6 on day of life 5 was associated with prolonged duration of ROP.
Conclusions :
This study confirms prior findings that increased severity of ROP is associated with later GA at MSROP and CV and prolonged duration of regression. New associations were found between slower neonatal growth and inflammatory comorbidities and prolonged or delayed ROP regression. These findings suggest that infants with these comorbidities may require longer surveillance for resolution of ROP.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.