Risk Factors of Threshold Retinopathy of Prematurity in Preterm Infants with Bronchopulmonary Dysplasia

ABSTRACT

PURPOSE: We tried to clarify perinatal risk factors that are related to the occurrence of threshold retinopathy of prematurity in preterm infants with bronchopulmonary dysplasia. METHODS: We enrolled 40 infants with bronchopulmonary dysplasia who had received ophthalmologic examination between April 1995 and May 2001. The patients were categorized into two groups; "threshold retinopathy of prematurity" group as study (n=18), and "no retinopathy of prematurity" and "prethreshold retinopathy of prematurity" group as control population (n=22), and we compared the perinatal risk factors between the two. RESULTS: Out of total 40 preterm infants with bronchopulmonary dysplasia, only prethreshold retinopathy of prematurity occurred in 6 infants (15%) and threshold retinopathy of prematurity developed in 18 infants(45%). The incidence of threshold retinopathy of prematurity decreased with longer gestation and higher birth weight. Mean gestational age was 26.3 weeks in the study group vs 29.4 weeks in control group, and mean birth weight was 868 g and 1,413 g, respectively. An increased risk of reaching threshold retinopathy of prematurity was found associated with apnea, longer use of aminophylline, hyperglycemia, and higher SNAP scores during the first 24 hours from admission to the NICU. The incidence of threshold retinopathy of prematurity was not influenced by duration of oxygen therapy, ventilator therapy, total parenteral nutrition, phototherapy, hospitalization, intraventricular hemorrhage, pneumonia, pulmonary hemorrhage, sepsis, patent ductus arteriosus, air leak syndrome, necrotizing enterocolitis, frequency of transfusion, and longer use of dexamethasone. CONCLUSION: An increased risk of reaching threshold retinopathy of prematurity in preterm infants with bronchopulmonary dysplasia was found associated with lower birth weight, younger gestational age, apnea, longer use of aminophylline, hyperglycemia, and higher SNAP scores during the first 24 hours from admission to the NICU.