Risk Factors for Retinopathy of Prematurity Requiring Laser Treatment in Preterm Infants Born Before 28 Weeks of Gestation

Purpose: To investigate the risk factors for retinopathy of prematurity (ROP) requiring laser treatment in preterm infants born before a gestational age (GA) of 28 weeks. Methods: This was a single-institution retrospective case-control study of high-risk preterm infants (GA ≤28 weeks) with ROP who were, born between January 2008 and December 2016. Patients who underwent laser treatment for severe ROP were enrolled. Infants in the control group were matched to preterm infants with a similar GA and mild ROP who, did not require laser treatment. Various prenatal and postnatal risk factors were compared between the two groups. Results: One hundred and twenty-two infants were included in this study (61 cases and 61 controls). The average birth weight was similar between the two groups (895.2±172.9 g vs. 938.5±168.0 g, P=0.164). There was no significant difference in the duration of invasive ventilation; however, the duration of noninvasive mechanical ventilation was significantly longer in patients (with ROP) who underwent laser treatment (P=0.036). The proportion of infants at a postnatal age of 28 days who were receiving oxygen treatment was significantly higher (60/61 [98.4%] vs. 51/61 [83.6%], P=0.004) in the severe ROP group. However, the rates of oxygen treatment for infants with a GA of 36 weeks were not significantly different (59%, for both groups). Other prematurity-associated morbidities were similar between the two groups. Conclusion: Altogether, a judicious reduction of oxygen therapy might reduce the incidence of laser treatment. Early diagnosis and treatment through periodic ophthalmologic examination are necessary in preterm infants receiving oxygen treatment at 28 days after birth.