Surfactant replacement therapy: A new risk factor in developing retinopathy of prematurity?

Abstract

We documented the prevalence of retinopathy of prematurity (ROP) in a group of 46 infants suffering from a moderate or severe respiratory distress syndrome and treated with surfactant replacement therapy (SRT) and 61 controls admitted in the year prior to the institution of SRT. Mortality in the treatment group was lower than in the control group (15.5% versus 23.8; P = 0.29). The ROP prevalence in the treatment group was 47.8% and in the control group 27.9%. To analyse the contribution of SRT alone to the prevalence of ROP, multivariate analysis using logistic regression technique was used. The odds ratio for SRT was 5.2 with a 95% confidence interval of 1.3-20.7, P = 0.02. The prevalence of severe ROP in the surfactant treated group was not increased compared to the control group. From our data we conclude that SRT increases the risk of developing ROP but is not associated with more severe forms of ROP.

Postnatal risk factors of retinopathy of prematurity

“…While one study showed no significant association between prophylactic surfactant therapy and the incidence of ROP, 4 other studies reported that use of surfactant increased the risk of developing ROP 21,22 . In our hospital, surfactant treatment was done only for rescue, not for prophylaxis.…”

Risk Factors in the Development of Mild and Severe Retinopathy of Prematurity

“…Although one study showed no significant association between prophylactic surfactant therapy and the incidence of ROP, 17 other studies reported that the use of surfactant increased the risk of developing ROP. 18,19 In our study, surfactant therapy, used for prophylaxis, in logistic regression did not show a significant influence on ROP incidence in both the mild and the severe ROP group.…”

Pharmacologic interventions for the prevention and treatment of retinopathy of prematurity

“…One of the earlier drugs found to be associated with ROP is surfactant, despite conflicting reports. In the 1990s, there were 3 report of a higher occurrence of ROP with surfactant use (218)(219)(220). However, comparing the two commonly used surfactants at that time, Exosurf and Survanta, there was a higher occurrence of ROP in the Exosurf group (220).…”