Effect of supplemental oxygen on development of retinopathy of prematurity

Abstract

Background: Retinopathy of prematurity (ROP) which is also known as retrolental fibroplasia is a vasoproliferative disorder that affects premature infants. Despite of major advancement in management, it continues to be a leading cause of childhood blindness throughout the world. As there had been very few studies conducted here and very few information regarding this disease are available we conducted this study. Aim of the study: The aim of this study was to evaluate the effect of supplemental Oxygen on development of retinopathy of prematurity. Methods: This was a prospective cohort study which was conducted at the Special Care Baby Unit (SCABU) and Intensive Care Unit (ICU) of Dhaka Shishu (Children) Hospital, Dhaka, Bangladesh during the period from July 2012 to December 2014. In total One Hundred and Twenty (120) 0-28 day's old neonates of both sexes possibilities of ROP were finalized as the study population. Data were processed and analyzed using statistical software SPSS version 17, EPI info 7. Result: In this study, thirty (36.59%) neonates got oxygen up to 72 hours did not developed ROP. Only one 1(2.63%) ROP (+ve) neonates received oxygen for 73 to 120 hours. Those who received oxygen for duration of 170-218 hours and >218 hours developed ROP, RR was 2.01 [1.17-3.48] and 4.67 [2.71-8.03] respectively and (p<0.05). On the other hand, five neonates (13.16%) of ROP (+ve) got percentage of oxygen in inhaled air (41-60)% and this concentration was found statistically significant risk for ROP, RR 3.48 [2.61-4.64] but there was no risk associated with FiO2 (24-32)% or 33-40% in inhaled air. SpO2 (95-99) % was present in 29 (76.32%) of ROP (+ve) neonates and 19 (23.17%) in ROP (-ve) neonates. Conclusion: The practice of providing oxygen and blood transfusion are often lifesaving, a more judicious approach to the use of such therapies may help to reduce the problem of ROP. Inappropriate supplementation of oxygen may not correct hypoxia or may lead to hyperoxia. Both the conditions are injurious to neonatal health. During oxygen therapy, SpO2 value and more precisely the PaO2 value on neonate should be maintained within a target range. The finding of this study should be explored in the future.

Association of Oxygen Therapy Concentration and Duration with Retinopathy of Prematurity Incidence at Naresuan University Hospital

“…These findings are consistent with those reported in several other studies. 4,5,[8][9][10] However, the observed range of FiO2 in this study contradicts the findings by Das, et al, 4 who reported an association of ROP with FiO2 ranging from 0.41 to 0.60. This discrepancy could stem from differences in the timing of outcome measurements.…”

“…2 Interestingly, this study not only highlighted the role of oxygen concentration, but also demonstrated that the duration of oxygen therapy in the ROP group was significantly longer compared to the non-ROP group, a finding consistent with previous studies. 4,5,[11][12][13] Moreover, the relationship between oxygen therapy duration and ROP severity was substantiated by a mean difference regression analysis. The results revealed a statistically significant correlation between the duration of oxygen therapy and the severity of ROP.…”

“…This discrepancy could stem from differences in the timing of outcome measurements. Das et al 4 performed the outcome measurement at the third and final ophthalmologic examination, while the current study carried out the assessment at the initial ophthalmologic examination.…”

“…Das et al conducted a prospective cohort study to evaluate the effect of supplemental oxygen on the development of ROP at Dhaka Shishu Hospital, Bangladesh from July 2012 to December 2014. 4 The study included infants with a birth weight ≤2500 g or born at <34…”

Retinopathy of Prematurity: A Study of Incidence and Risk Factors in a Tertiary Hospital in Vietnam

“…8,12 Some previous studies reported that oxygen supplementation was associated with ROP due to its effect on retinal vessel development: supplemental oxygen can interfere with oxygen tension and a high concentration of oxygen can lead to oxidative stress, which increases retinal ischemia, resulting in ROP. 1,9,11,12,18 Factors related to oxygen supplementation, by CPAP and/or mechanical ventilation remained statistically significant on multivariate analysis. Reyes et al and Akkawi et al also found that invasive ventilation, oxygen therapy increase the risk of developing ROP.…”