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Early curtailment of oxygen therapy lowers incidence of ROP

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WAIKOLOA, Hawaii — The incidence of severe retinopathy of prematurity in low birth weight and premature infants significantly decreased after the use of oxygen therapy was reduced, said a physician speaking here.

“Before the early curtailment of oxygen supplements to premature babies, our center had a high incidence of severe retinopathy of prematurity (ROP),” Kenneth W. Wright, MD, said here during the annual meeting of the American Association for Pediatric Ophthalmology and Strabismus.

In March 1998, researchers at the Cedars-Sinai Medical Center in Los Angeles implemented a new oxygen protocol for infants weighing less than 1,500 grams. Dr. Wright and colleagues performed a retrospective study comparing the outcomes of infants’ ROP and threshold ROP before and after the new oxygen protocol.

“We evaluated the charts of 80 patients before the new protocol and 221 patients after the new protocol,” Dr. Wright said. “After the new therapy, ROP significantly decreased.” He noted a significant decrease in the incidence of stage 3 and stage 4 ROP was seen from 1999 to 2001 (P = .0118). A significant decrease in the incidence of laser therapy use for threshold ROP was also noted (P = .006).

While a decrease of oxygen therapy in premature infants has been shown to increase mortality rates, Dr. Wright said that infant survival at his center improved slightly after the new oxygen protocol. The new protocol resulted in a survival rate of 89%, compared with 80% with the previous protocol.