Retinopathy of Prematurity in Very Low Birth Weight Infants and the Potential Protective Role of Indomethacin

Abstract

To describe clinical features of very low birth weight (VLBW) infants and examine the effect of indomethacin on the incidence of retinopathy of prematurity (ROP). Medical records of all VLBW infants over a 4-year period were reviewed. Data regarding systemic and ophthalmic examinations were analyzed. Forty-seven infants with ROP were evaluated. Most infants had bilateral stage 1 or 2 disease extending 5 clock hours. Infants with ROP had younger mean gestational age, had lower gestational weight, and demonstrated higher incidence of diseases of prematurity. These infants were exposed to increased doses of surfactant and higher oxygen concentration for a prolonged duration given their immature pulmonary status. Independent predictors of ROP susceptibility also included length of hospitalization and Apgar score at 5 minutes. Patent ductus arteriosus was more common among infants with ROP. Approximately half of the infants who received one or two doses of indomethacin had ROP, but the ROP rate was decreased in infants who received three doses. Premature infants with younger gestational age, lower gestational weight, and severe morbidities were found to have an increased prevalence of ROP. Indomethacin treatment for patent ductus arteriosus may have a protective role in the development of severe ROP.