Retinopathy of prematurity (ROP) and indomethacin therapy in premature infants with paten ductus arterious (PDA)

Yeh, T. F.; Raval, D.; Pyati, Suma; Pildes, S.

doi:10.1016/0090-6980(83)90041-2

Cited by 19 publications

(5 citation statements)

References 9 publications

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“…Many reports have shown that indomethacin prophylaxis does not increase the incidence of ROP (25)(26)(27). In the present study, it was found that the incidence of ROP was higher in infants who received indomethacin as prophylaxis for IVH.…”

Section: Discussionsupporting

confidence: 45%

Risk Factors for Acute Retinopathy of Prematurity

et al. 2007

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We prospectively studied the risk factors and the incidence of retinopathy of prematurity (ROP) in 195 consecutive preterm infants. Birth weight and duration of mechanical ventilation were the only factors that were significantly associated with the incidence of ROP. While indomethacin increases the risk of developing ROP, maternal antenatal steroids have a protective effect against the development of severe stages of ROP. The presence of intraventricular hemorrhage increases the risk of severe ROP.

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Section: Discussionsupporting

confidence: 45%

Risk Factors for Acute Retinopathy of Prematurity

et al. 2007

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“…We report here that ocular Keto and systemic Caff together exert a synergistic protective effect on OIR. Previous studies showed that Caff decreases severe ROP ( 13 , 14 ) and NSAIDs may prevent ROP in humans ( 21 , 22 , 23 ) and animal models ( 18 , 20 , 30 ). Caffeine has been used in combination with NSAIDs for many decades to enhance their analgesic and anti-inflammatory effects ( 31 , 32 , 33 ), suggesting that caffeine may be an effective adjuvant to NSAIDs.…”

Section: Discussionmentioning

confidence: 97%

“…Studies on growth factors and morphogens such as Sonic Hedgehog ( 15 ), VEGF and hypoxia-inducible factor (HIF)-1α ( 16 ), as well as matrix degrading enzymes ( 17 ), indicate that Caff exerts powerful effects on these molecular events that may lead to the observed protective effect on ROP. Prostanoids are involved in the development of oxygen-induced retinopathy (OIR) and the cross-talk between VEGF, oxidative stress, and cyclooxygenase (COX) pathways ( 18 , 19 , 20 , 21 , 22 , 23 ). Ketorolac (Keto) eye drops, an ophthalmic NSAID that inhibit COX, had been used safely and had decreased ROP in ketorolac treated preterm infants compared to a historical control ( 23 ).…”

mentioning

confidence: 99%

Pharmacologic synergism of ocular ketorolac and systemic caffeine citrate in rat oxygen-induced retinopathy

et al. 2016

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Background:Caffeine or ketorolac decrease the risk of retinopathy of prematurity and may act synergistically to improve beneficial effect. Combination of caffeine (Caff) and ketorolac (Keto) to prevent oxygen-induced retinopathy was studied.Methods:Newborn rats exposed to room air (RA) or intermittent hypoxia (IH) consisting of 12% O2 during hyperoxia (50% O2) from birth (P0) had single daily IP injections of Caff from P0-P13 or saline; and/or ocular Keto (Acuvail, 0.45% ophthalmic solution) administered subcutaneously over the eyes from P5-P7. Pups were studied at P14 or placed in RA for recovery from IH (IHR) until P21. Eyes were examined for neovascularization, histopathology, growth factors, and VEGF-signaling genes.Results:Severe retinal damage noted during IHR in the untreated groups evidenced by hemorrhage, neovascularization, and oxygen-induced retinopathy (OIR) pathologies were prevented with Keto/Caff treatment. Keto and/or Caff treatment in IH also promoted retinal neural development evidenced by eye opening (92%, P < 0.001 vs. 31% in the placebo-treated IH group). No corneal pathologies were noted with Keto.Conclusion.Caff or Keto given individually reduced retinal neovascularization, but the two drugs given together prevented severe OIR.

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“…Indomethacin is a non-selective COX inhibitor used in neonatology for closure of a patent ductus arteriosus. While studies found no relationship between indomethacin and ROP (257,258), one retrospective study of over 34,000 preterm infants from 162 sites showed a higher incidence of severe ROP (stages 3 and 4) in the group treated with indomethacin on the first day of life (259). Darlow et al (260) reported that infants treated with indomethacin were 1.5 times more likely to have ROP than untreated infants.…”

Section: Indomethacinmentioning

confidence: 99%

Pharmacologic interventions for the prevention and treatment of retinopathy of prematurity

Aranda

Valencia

et al. 2019

Seminars in Perinatology

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Retinopathy of prematurity (ROP), a significant morbidity in prematurely born infants, is the most common cause of visual impairment and blindness in children and persists till adulthood. Strict control of oxygen therapy and prevention of intermittent hypoxia are key in the prevention of ROP, but pharmacologic interventions have decreased risk of ROP. Various drug classes such as methylxanthines (caffeine), VEGF inhibitors, anti-oxidants, and others have decreased ROP occurrence. The timing of pharmacologic intervention remains unsettled, but early prevention rather than controlling disease progression may be preferred. These drugs act through different mechanisms and synergistic approaches should be considered to maximize efficacy and safety.

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Retinopathy of prematurity (ROP) and indomethacin therapy in premature infants with paten ductus arterious (PDA)

Cited by 19 publications

References 9 publications

Risk Factors for Acute Retinopathy of Prematurity

Risk Factors for Acute Retinopathy of Prematurity

Pharmacologic synergism of ocular ketorolac and systemic caffeine citrate in rat oxygen-induced retinopathy

Pharmacologic interventions for the prevention and treatment of retinopathy of prematurity

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