Efficacy and Safety of Prophylactic Agents in Prevention of Retinopathy of Prematurity: A Systematic Review and Meta-analysis of Randomised Controlled rials

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#humans #retinopathy-of-prematurity #randomized-controlled-trials-as-topic #infant-newborn #propranolol

Efficacy and Safety of Prophylactic Agents in Prevention of Retinopathy of Prematurity: A Systematic Review and Meta-analysis of Randomised Controlled rials

Batais et al., 2024 | BMJ Open Ophthalmol | Meta Analysis

Citation

Batais Waleed T, Taher Nada O, ... Qurashi Mansour A. Efficacy and Safety of Prophylactic Agents in Prevention of Retinopathy of Prematurity: A Systematic Review and Meta-analysis of Randomised Controlled rials. BMJ Open Ophthalmol. 2024-Dec-25;9(1). doi:10.1136/bmjophth-2024-001910

Abstract

OBJECTIVE: Retinopathy of prematurity (ROP) is a leading cause of preventable childhood blindness in preterm infants with low birth weight. The efficacy and safety of prophylactic agents, including vitamin A, propranolol and lipids, in reducing ROP incidence remain unclear. This systematic review and meta-analysis evaluated the effectiveness and safety of these agents in preventing ROP. METHODS AND ANALYSIS: A systematic search was conducted in Embase, MEDLINE and CENTRAL databases. Eight randomised controlled trials involving 1101 preterm infants were included. We assessed the incidence of ROP at any stage, severe ROP, adverse events and mortality. Subgroup analyses were performed for each prophylactic agent. Data were pooled using the inverse variance weighting method and reported as risk ratios (RRs) with 95% CI. RESULTS: No significant reduction in ROP incidence at any stage was found in the intervention groups compared with placebo (RR=0.83; 95% CI= (0.69 to 1.00); p=0.05; I²=0%). Lipids significantly reduced severe ROP incidence (RR=0.48; 95% CI= (0.28 to 0.80); p=0.005), while vitamin A (RR=1.14; 95% CI= (0.51 to 2.54); p=0.75) and propranolol (RR=0.69; 95% CI= (0.29 to 1.65); p=0.41) did not. There were no significant differences in adverse events (RR=0.83; 95% CI= (0.59 to 1.17); p=0.28) or mortality (RR=0.93; 95% CI= (0.67 to 1.30); p=0.68) across all groups. CONCLUSION: Lipids show promise in reducing severe ROP in preterm infants, while vitamin A and propranolol were not effective. Further research is needed to confirm these findings and explore the potential role of lipids in clinical practice.

Key Findings

No significant reduction in ROP incidence at any stage was found in the intervention groups compared with placebo (RR=0.83; 95% CI= (0.69 to 1.00); p=0.05; I²=0%). Lipids significantly reduced severe ROP incidence (RR=0.48; 95% CI= (0.28 to 0.80); p=0.005), while vitamin A (RR=1.14; 95% CI= (0.51 to 2.54); p=0.75) and propranolol (RR=0.69; 95% CI= (0.29 to 1.65); p=0.41) did not. There were no significant differences in adverse events (RR=0.83; 95% CI= (0.59 to 1.17); p=0.28) or mortality (RR=0.

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size See abstract
Age Range See abstract
Condition See abstract

MeSH Terms

  • Humans
  • Retinopathy of Prematurity
  • Randomized Controlled Trials as Topic
  • Infant, Newborn
  • Propranolol
  • Vitamin A
  • Incidence
  • Infant, Premature
  • Lipids

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Systematic Review, Meta-Analysis
  • Vertical: vitamin-a

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09