Early aggressive intravenous fat emulsion decreases the incidence of retinopathy of prematurity

ABSTRACT

This study aimed to evaluate the effect of early aggressive introduction of intravenous fat emulsion [IVFE] on the occurrence of retinopathy of prematurely [ROP]. A retrospective study conducted at Prince Hashem Ben Al- Hussein Military Hospital A 100 premature infants of gestational age [G.A] and /or of < 1500 grams, all who needed oxygen support for respiratory distress syndrome and who not received and who received either early aggressive or late non-aggressive intravenous fat emulsion and all who underwent an eye examination for retinopathy of prematurity. Of total 100 [49 Males 51 Females] premature infants studied 17 [17%] found to have ROP of them [7 males and 10 females] and 11 [64.7%] found to have unilateral involvement and 6 [35.3%] had bilateral involvement. Stage 3 and more found to associate with bilateral eye disease in 80% of patients. 7% have had stage [1], 5% stage [2], 4% stage [3], 1% stage [4] and none had stage [5]. Of the 32 premature infants who received early aggressive IVFE [15 Males and 17 Females] 4 [12.5%] diagnosed to have ROP of them [2 males and 2 females], with 3 unilateral ROP and 1 with bilateral ROP. 9.4% with stage [1], 3.1% with stage [3] and none of them had stage 2,4 or 5. Of the 33 preterm infants who received late non aggressive IVFE [16 Males and 17 Females] 5[15%] documented to have ROP, of them [2 males and 3 females]. Unilateral involvement found in 4[80%] where bilateral involvement in 1[20%] of them. In this group 6% had stage [1], 2% stage [2], 3% stage [3] and no single preterm infant had stage 4 or 5. Of the 35 premature infants who did not receive IVFE at all [18 Males and 17 females] 8[22,8%] developed ROP of them 3 males and 5 females. 4[50%] had unilateral ROP and 4[50%]had bilateral diseased eyes. 5.7% developed stage [1] ROP, 8.5% stage [2], 5.7% stage [3], 2.8% stage[4] and none had stage 5. Premature infants gestation at birth have had the highest incidence [35.9% and 25.5% respectively] and more severe form of the disease. The occurrence of retinopathy of prematurity is more common in females than males [M F = 14.3%19.6%] and unilateral involvement much more than bilateral involvement [64.7%35.3%]. Early aggressive introduction of intravenous fat emulsion associated with better retinal development in preterm infants and thus decrease the incidence of retinopathy of prematurity