Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2024 Dec 25;9(1):e001910.
doi: 10.1136/bmjophth-2024-001910.

Efficacy and Safety of Prophylactic Agents in Prevention of Retinopathy of Prematurity: A Systematic Review and Meta-analysis of Randomised Controlled rials

Waleed T Batais  1   2 , Nada O Taher  1   2 , Abeer K Alhindi  1   2 , Abdullah A Ghaddaf  1   2 , Anas Alamoudi  3 , Sarah A Al-Ghamdi  4 , Jumanah J Homsi  5   6 , Hashem S Almarzouki  1   7 , Mansour A Qurashi  1   8
Affiliations
Meta-Analysis

Efficacy and Safety of Prophylactic Agents in Prevention of Retinopathy of Prematurity: A Systematic Review and Meta-analysis of Randomised Controlled rials

Waleed T Batais et al. BMJ Open Ophthalmol. .

Abstract

Objective: Retinopathy of prematurity (ROP) is a leading cause of preventable childhood blindness in preterm infants with low birth weight. The efficacy and safety of prophylactic agents, including vitamin A, propranolol and lipids, in reducing ROP incidence remain unclear. This systematic review and meta-analysis evaluated the effectiveness and safety of these agents in preventing ROP.

Methods and analysis: A systematic search was conducted in Embase, MEDLINE and CENTRAL databases. Eight randomised controlled trials involving 1101 preterm infants were included. We assessed the incidence of ROP at any stage, severe ROP, adverse events and mortality. Subgroup analyses were performed for each prophylactic agent. Data were pooled using the inverse variance weighting method and reported as risk ratios (RRs) with 95% CI.

Results: No significant reduction in ROP incidence at any stage was found in the intervention groups compared with placebo (RR=0.83; 95% CI= (0.69 to 1.00); p=0.05; I²=0%). Lipids significantly reduced severe ROP incidence (RR=0.48; 95% CI= (0.28 to 0.80); p=0.005), while vitamin A (RR=1.14; 95% CI= (0.51 to 2.54); p=0.75) and propranolol (RR=0.69; 95% CI= (0.29 to 1.65); p=0.41) did not. There were no significant differences in adverse events (RR=0.83; 95% CI= (0.59 to 1.17); p=0.28) or mortality (RR=0.93; 95% CI= (0.67 to 1.30); p=0.68) across all groups.

Conclusion: Lipids show promise in reducing severe ROP in preterm infants, while vitamin A and propranolol were not effective. Further research is needed to confirm these findings and explore the potential role of lipids in clinical practice.

Keywords: Child health (paediatrics); Retina; Treatment Medical; Vision; Visual perception.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1. Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow chart demonstrating the process of screening and selecting studies. RCT, randomised controlled trial.
Figure 2
Figure 2. Meta-analysis and subgroup analysis of ROP of any stage by intervention comparing lipids, vitamin A, and propranolol. ROP, retinopathy of prematurity; IV, inverse variance.
Figure 3
Figure 3. Meta-analysis and subgroup analysis of adverse events by intervention comparing lipids, vitamin A, and propranolol. IV, inverse variance.
See this image and copyright information in PMC

References

    1. Gilbert C. Retinopathy of prematurity: a global perspective of the epidemics, population of babies at risk and implications for control. Early Hum Dev. 2008;84:77–82. doi: 10.1016/j.earlhumdev.2007.11.009. - DOI - PubMed
    1. Azad R, Chandra P. Retinopathy of prematurity. J Indian Med Assoc. 2005;103:370–2. - PubMed
    1. Agarwal K, Jalali S. Classification of retinopathy of prematurity: from then till now. Community Eye Health. 2018;31:S4–7. - PMC - PubMed
    1. Blencowe H, Lawn JE, Vazquez T, et al. Preterm-associated visual impairment and estimates of retinopathy of prematurity at regional and global levels for 2010. Pediatr Res. 2013;74 Suppl 1:35–49. doi: 10.1038/pr.2013.205. - DOI - PMC - PubMed
    1. Aranda JV, Qu J, Valencia GB, et al. Pharmacologic interventions for the prevention and treatment of retinopathy of prematurity. Semin Perinatol. 2019;43:360–6. doi: 10.1053/j.semperi.2019.05.009. - DOI - PubMed

MeSH terms

LinkOut - more resources