Evaluating the association of autonomic drug use to the development and severity of retinopathy of prematurity

Purpose To explore the association of autonomic agents with the development and severity of retinopathy of prematurity (ROP). Methods The medical records of all preterm infants screened for ROP were retrospective reviewed. The association between development and severity of ROP and the use and dose(s) of autonomic agents was analyzed, after adjustment for the covariates gestational age, weight, development of septicemia, intraventricular hemorrhage, and respiratory distress syndrome. Results A total of 350 infants were screened. Caffeine was used in 338 infants; dopamine in 98 infants. There was a significant association between the use of dopamine and development of ROP ( P < 0.001; relative risk [RR] = 1.6 [95% CI, 1.23-2.06]) and the need for ROP treatment ( P = 0.001; RR = 4.63 [95% CI, 1.82-11.79]). The number of dopamine doses was significantly associated with the development of any ROP ( P < 0.001; RR = 1.07 [95% CI, 1.03-1.1]), the severity of ROP ( P < 0.001; RR = 1.09 [95% CI, 1.05-1.14]), and the need for treatment ( P < 0.001; RR = 1.09 [95% CI, 1.05-1.14]). The total dose of caffeine was significantly associated with the development of any ROP ( P = 0.003; RR = 1.03 [95% CI, 1.01-1.05]) and the need for treatment ( P = 0.006, RR = 1.073 [95% CI; 1.021-1.13]). Conclusions Although a causal relationship was not identified, the use of the autonomic agents caffeine and dopamine was associated with the development and severity of retinopathy of prematurity in this cohort.