Betablockers for prevention and treatment of retinopathy of prematurity in preterm infants (88 Kaempfen S, Neumann RP, Jost K, Schulzke SM. Beta-blockers for prevention and treatment of retinopathy of prematurity in preterm infants. Cochrane Database Syst Rev. 2018 Mar;3:CD011893.)
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Neonates of less than 37 weeks' gestational age. |
To determine the effect of beta-blockers used as prophylactic either as treatment in ROP. |
Oral propranolol (2 mg/ml syrup) at a dose of 0.5 mg/kg 6 hourly to (1 mg/ml saline solution) at a dose of 0.5 mg/kg 6-hourly. |
Beneficial effects on the risk of requiring anti-VEGF agents. Beneficial effects of oral beta-blockers on the risk of requiring laser therapy. Beneficial effect of oral beta-blockers on progression to stage 3 ROP but not to stage 2 ROP with plus disease or to stage 4 or 5 ROP. Meta-analysis did not indicate a significant effect on arterial hypotension, bradycardia, complications of prematurity or mortality. None of the trials reported visual impairment. |
Low quality of evidence. Low quality of evidence. Moderate quality of evidence Low quality of evidence. |
Anti-vascular endothelial growth factor (VEGF) drugs for treatment of retinopathy of prematurity (99 Sankar MJ, Sankar J, Chandra P. Anti-vascular endothelial growth factor (VEGF) drugs for treatment of retinopathy of prematurity. Cochrane Database Syst Rev. 2018 Jan;1:CD009734.)
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Anti-VEGF compared with conventional laser therapy or laser/cryotherapy in preterm infants with type 1 ROP. |
To evaluate the efficacy and safety of anti-VEGF alone or associated with crio/laser. |
Monotherapy: using only intravitreo anti- VEGF; Combination therapy: anti-VEGF with cryo/laser therapy; |
Bevacizumab/ranibizumab as monotherapy did not reduce the risk of complete or partial retinal detachment. The risk of recurrence of ROP requiring retreatment did not differ between groups. Infants who received intravitreal bevacizumab had a significantly lower risk of refractive errors (very high myopia) at 30 months of age. Pegaptanib with laser therapy reduce the risk of retinal detachment when compared to laser/cryotherapy alone. There was no difference in the risk of perioperative retinal haemorrhages between the two groups. |
Very low quality of evidence. Very low quality of evidence. Low quality of evidence. Low quality of evidence. Very low quality of evidence. |
D-Penicillamine for preventing retinopathy of prematurity in preterm infants (1010 Qureshi MJ, Kumar M. D-Penicillamine for preventing retinopathy of prematurity in preterm infants. Cochrane Database Syst Rev. 2013 Sep;9(9):CD001073.)
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Incidence and progression of ROP. |
To determine the effect of prophylactic of D-penicillamine on the incidence of acute ROP or severe ROP in preterm infants. |
D-penicillamine intravenous compared with no treatment or placebo. |
The meta-analysis showed no significant differences in the risk of any stage nor severe ROP or death in all participants as well as in the subgroup of infants under 1500 g birth weight. No side effects nor spasticity or developmental delay in one year found significant differences. |
Not related. |
Early light reduction for preventing retinopathy of prematurity in very low birth weight infants (1111 Jorge EC, Jorge EN, El Dib RP. Early light reduction for preventing retinopathy of prematurity in very low birth weight infants. Cochrane Database Syst Rev. 2013 Aug;8(8):CD000122.)
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Reduced light exposure to premature infants within the first seven days. |
To determine whether light exposure reduces the incidence or progression of RoP among very low birth weight infants. |
The reduction of early light exposure, it was not related light parameters. |
This study did not show benefit on reduction of light exposure in preterm infants of any weight in prevention RoP. |
Not related. |
Local anaesthetic eye drops for prevention of pain in preterm infants undergoing screening for retinopathy of prematurity (1212 Dempsey E, McCreery K. Local anaesthetic eye drops for prevention of pain in preterm infants undergoing screening for retinopathy of prematurity. Cochrane Database Syst Rev. 2011 Sep;9(9):CD007645.)
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Premature Infant Pain Profile (PIPP) score of pain with topical anaesthetic eye drops. |
To assess pain during eye exam by the PIPP scale with or without the use of anesthetic eye drops. |
Amethocaine, proxymetacaine, tetracaine and oxybuprocaine. |
There is a non-significant reduction in pain scores at one minute and a non-significant increase at five minutes after speculum insertion. The PIPP score> 12 PIPP> 4 in one minute resulted in a reduction of pain favorable to the use of the statistically significant anesthetic |
Not related. |
Supplemental oxygen for the treatment of prethreshold retinopathy of prematurity (1313 Lloyd J, Askie L, Smith J, Tarnow-Mordi W. Supplemental oxygen for the treatment of prethreshold retinopathy of prematurity. Cochrane Database Syst Rev. 2003;2(2):CD003482.)
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Preterm or low birth weight infants with ROP. |
To determine wether supplemental oxygen reduces the progression of ROP and improves visual outcome. |
It does not describe the amount of oxygen. |
A single trial has shown that complementary oxygen has a tendency to reduce the progression of ROP; in infants without RoP showed significantly fewer children who progressed to the ROP threshold. No significant effects were observed in blindness or severe visual function at three months. Long-term visual outcomes were not reported. |
Not related. |
Peripheral retinal ablation for threshold retinopathy of prematurity in preterm infants (1414 Andersen CC, Phelps DL. Peripheral retinal ablation for threshold retinopathy of prematurity in preterm infants. Cochrane Database Syst Rev. 2000;3(2):CD001693.)
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Infants with threshold ROP. |
Does peripheral retinal ablation, by any means, reduce the incidence of adverse ophthalmic outcome? |
Was considerd cryotherapy, laser diode, laser argon, xenon arc photocoagulation. |
Two trials showed laser favorable to reduce the risk of early unfavorable retinal structure as well as in early childhood and invisual acuity in early childhood. In addition, visual fields in sighted eyes were slightly smaller in the treated group. |
Not related. |