The efficacy of propranolol in very preterm infants at the risk of retinopathy of prematurity: Which newborn and when?

PURPOSE: Retinopathy of prematurity (ROP), a proliferative vitreoretinopathy resulting from the vascular disorder of the retina, is the most frequent cause of blindness in childhood. In our time, ROP in advanced stage, a serious problem in premature infants, has no other treatment more effective and with fewer side effects than laser photocoagulation (LPC) treatment, which narrows visual field. The search for methods with fewer side effects than LPC has increased in recent times for the treatment of ROP. We aimed to investigate the effects in question of propranolol on ROP in various stages (stages 1, 2, and 3 ROP).

METHODS: This study is designed as a randomized, placebo-controlled, single-centered, double-blind clinical trial with parallel groups. A total of 126 very preterm infants, followed up in our unit from April 2011 to January 2013, were randomly selected and included in our study. They were separated into the groups of 0, 1, and 2 depending on their stage of ROP. In addition, all the patients were divided into control group (CG) and propranolol treatment group (PTG). While the cases in the CG were administered physiological saline solution, the cases in the PTG were administered propranolol (2 mg/kg/day) in the neovascularization phase (second phase) of the ROP.

RESULTS: Propranolol given to the group of stage 0-1 ROP was observed to have had no effect on the level of statistical significance between the CG and PTG in terms of increase in ROP stages (p > 0.05). However, propranolol was found to be more useful in patients with stage 2 ROP (p < 0.05).

CONCLUSION: When given in the neovascularization phase of the ROP, propranolol was found to be effective in the stage 2 (advanced stage) ROP patients but in stage 0-1 (early-stage) ROP patients, its efficacy was not sufficient.