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Early Treatment of Blinding Eye Disease in Premature Infants Can Prevent Severe Vision Loss

December 8, 2003 — (adapted from an NEI news release)-The results of a clinical trial sponsored by the National Eye Institute, National Institutes of Health, may help ophthalmologists better treat premature infants suffering from a blinding eye disease known as retinopathy of prematurity (ROP). The disorder primarily affects premature infants who are born before 31 weeks of gestation and weigh less than 2.75 pounds.

The Early Treatment for Retinopathy of Prematurity (ETROP) study results, published in the December issue of the Archives of Ophthalmology, demonstrated that certain premature infants who are at highest risk for developing vision loss from ROP, retained better vision when therapy was administered earlier in the course of the disease. This treatment approach was found to be better than waiting until ROP had reached the traditional threshold (defined as a 50 percent chance of retinal detachment). Just as importantly, the study also established the value of an improved risk assessment model to more accurately identify those infants who are at the highest risk for developing severe vision loss from ROP.

Researchers found that early treatment significantly reduced the likelihood of poor vision in eyes with ROP from 19.5 percent to about 14.5 percent, and considerably reduced the likelihood of structural damage to the eye from 15.6 percent to 9.1 percent.

According to Robert Hoffman, M.D., a pediatric ophthalmologist at the Moran Eye Center and the lead Utah researcher on the study, the disease is caused when abnormal blood vessels grow from tissue that should be developing normal blood vessels in the retina, the membrane that lines the back of the eye. These abnormal vessels are fragile, can leak, and cause scarring the retina, pulling it out of position. The resulting retinal detachment is the main cause of visual impairment and blindness in children with ROP.

Ophthalmologists treat the disease using either laser therapy or cryotherapy. Both treatments destroy part of the outer portions of the retina, slowing or reversing the abnormal growth of blood vessels. Unfortunately, both treatments can also slightly reduce side vision.

“The key outcome of this study is the creation of new, simplified guidelines for treating ROP,” said Hoffman. “By identifying certain characteristics for ROP, we can predict which eyes are most likely to benefit from early treatment and save these infants from a lifetime of visual impairment. It is crucial that infants with severe ROP be identified early and be given timely treatment.”

In addition to Hoffman, University of Utah medical school faculty members David C. Dries, M.D., Paul S. Bernstein, M.D., Ph.D., Michael P. Teske, M.D., and Jerald D. King, M.D., served as co-investigators in the Utah portion of the study. Former faculty members Richard Olson, M.D., and Kimberly Yen, M.D., also participated in the study. The Moran Eye Center’s Susan Bracken, R.N., coordinated the Utah portion of the study.

The complete results of the ETROP study, as well as additional background information and photos, can be found on the NEI’s website at