Objective Retinopathy of prematurity (ROP), a vasoproliferative disorder of the retina in preterm infants, has been associated with multiple factors including levels of oxygenation. As intermittent hypoxemic events are common in preterm infants, this study investigates their association with the development of ROP. Study Design Oxygen desaturation events were quantified in 79 preterm infants (gestational age 24–27 6/7wks) during the first 8 weeks of life. Infants were classified as requiring laser treatment for ROP (LaserROP) versus less severe or no ROP. A linear mixed model was used to study the association between the incidence of intermittent hypoxia and LaserROP, controlling for gestational age, gender, race, multiple births and initial severity of illness. Results For all infants, there was an increase in hypoxemic events with increasing postnatal age (p<0.001). Controlling for all covariates, a higher incidence of oxygen desaturation events was found in the LaserROP infants (p<0.001), males (p<0.02) and infants of younger gestational age (p<0.003). Conclusion This study demonstrated a higher incidence of hypoxemic events in infants with ROP requiring laser therapy. Therapeutic strategies to optimize baseline oxygenation in preterm infants should include minimization of desaturation episodes, which may in turn decrease serious morbidity in this high risk population.

for the Infant Aphakia Treatment Study Group IMPORTANCE Glaucoma-related adverse events constitute major sight-threatening complications of cataract removal in infancy, yet their relationship to aphakia vs primary intraocular lens (IOL) implantation remains unsettled.OBJECTIVE To identify and characterize cases of glaucoma and glaucoma-related adverse events (glaucoma + glaucoma suspect) among children in the Infant Aphakia Treatment Study by the age of 5 years. DESIGN, SETTING, AND PARTICIPANTSA multicenter randomized clinical trial of 114 infants with unilateral congenital cataract in referral centers who were between ages 1 and 6 months at surgery. Mean follow-up was 4.8 years. This secondary analysis was conducted from December 23, 2004, to November 13, 2013.INTERVENTIONS Participants were randomized at cataract surgery to either primary IOL or no IOL implantation (contact lens). Standardized definitions of glaucoma and glaucoma suspect were created for the Infant Aphakia Treatment Study and applied for surveillance and diagnosis.MAIN OUTCOMES AND MEASURES Development of glaucoma and glaucoma + glaucoma suspect in operated on eyes for children up to age 5 years, plus intraocular pressure, visual acuity, and axial length at age 5 years.RESULTS Product limit estimates of the risk for glaucoma and glaucoma + glaucoma suspect at 4.8 years after surgery were 17% (95% CI, 11%-25%) and 31% (95% CI, 24%-41%), respectively. The contact lens and IOL groups were not significantly different for either outcome: glaucoma (hazard ratio [HR], 0.8; 95% CI, 0.3-2.0; P = .62) and glaucoma + glaucoma suspect (HR, 1.3; 95% CI, 0.6-2.5; P = .58). Younger (vs older) age at surgery conferred an increased risk for glaucoma (26% vs 9%, respectively) at 4.8 years after surgery (HR, 3.2; 95% CI, 1.2-8.3), and smaller (vs larger) corneal diameter showed an increased risk for glaucoma + glaucoma suspect (HR, 2.5; 95% CI, 1.3-5.0). Age and corneal diameter were significantly positively correlated. Glaucoma was predominantly open angle (19 of 20 cases, 95%), most eyes received medication (19 of 20, 95%), and 8 of 20 eyes (40%) underwent surgery.CONCLUSIONS AND RELEVANCE These results suggest that glaucoma-related adverse events are common and increase between ages 1 and 5 years in infants after unilateral cataract removal at 1 to 6 months of age; primary IOL placement does not mitigate their risk but surgery at a younger age increases the risk. Longer follow-up of these children may further characterize risk factors, long-term outcomes, potential differences between eyes having primary IOL vs aphakia, and optimal timing of unilateral congenital cataract removal. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00212134

No abstract