The effect of surfactant replacement therapy on retinopathy of prematurity

Retinopathy of prematurity is a disease characterized by an abnormal development of the retinal vessels in the premature or immature infant. If not treated in time it may lead to visual impairment or loss of vision. Although the exact pathogenesis has not yet been clarified many risk factors have been detected. As surfactant replacement therapy is associated with hyperoxia, hypercarbia and circulatory instability (all risk factors for retinopathy of prematurity), we performed a retrospective study to assess the effect of surfactant replacement therapy on the prevalence and severity of retinopathy of prematurity. Data of 160 surfactant-treated preterm infants were compared with data of 230 historic controls. The prevalence of retinopathy of prematurity was 30.6% in the treatment group and 23.4% in the control group. Severe retinopathy of prematurity (stage 3 or more) was seen in 6.1% of the infants with retinopathy of prematurity in the treatment group and 20.4% of the retinopathy of prematurity patients in the control group. Surfactant replacement therapy had no effect on the prevalence of retinopathy of prematurity (odds ratio 1.4, 95% confidence interval 0.797-2.459), but compared to mild retinopathy of prematurity surfactant replacement therapy was associated with a decreased risk for severe retinopathy of prematurity (odds ratio 0.226, 95% confidence interval 0.056-0.905). These data suggest that surfactant replacement therapy is associated with a decreased risk for severe retinopathy of prematurity.