Efficacy and Safety of Prophylactic Agents in Prevention of Retinopathy of Prematurity: A Systematic Review and Meta-analysis of Randomised Controlled Trials
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...
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| Language: | English |
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BMJ Publishing Group
2024-12-01
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| Series: | BMJ Open Ophthalmology |
| Online Access: | https://bmjophth.bmj.com/content/9/1/e001910.full |
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| author | Waleed T Batais Nada O Taher Abeer K Alhindi Abdullah A Ghaddaf Anas Alamoudi Sarah A Al-Ghamdi Jumanah J Homsi Hashem S Almarzouki Mansour A Qurashi |
| author_facet | Waleed T Batais Nada O Taher Abeer K Alhindi Abdullah A Ghaddaf Anas Alamoudi Sarah A Al-Ghamdi Jumanah J Homsi Hashem S Almarzouki Mansour A Qurashi |
| author_sort | Waleed T Batais |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-a027bd8577284276a0c27c926fa9580a |
| institution | Kabale University |
| issn | 2397-3269 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Ophthalmology |
| spelling | doaj-art-a027bd8577284276a0c27c926fa9580a2025-02-11T16:50:14ZengBMJ Publishing GroupBMJ Open Ophthalmology2397-32692024-12-019110.1136/bmjophth-2024-001910Efficacy and Safety of Prophylactic Agents in Prevention of Retinopathy of Prematurity: A Systematic Review and Meta-analysis of Randomised Controlled TrialsWaleed T Batais0Nada O Taher1Abeer K Alhindi2Abdullah A Ghaddaf3Anas Alamoudi4Sarah A Al-Ghamdi5Jumanah J Homsi6Hashem S Almarzouki7Mansour A Qurashi8King Abdullah International Medical Research Center, Jeddah, Saudi ArabiaCollege of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi ArabiaCollege of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi ArabiaCollege of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi ArabiaDepartment of Ophthalmology, Jeddah Eye Hospital, Jeddah, Saudi ArabiaOphthalmology Saudi Board Program, Jeddah Eye Hospital, Jeddah, Saudi ArabiaCollege of Medicine, King Abdulaziz University, Jeddah, Saudi ArabiaCollege of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi ArabiaCollege of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi ArabiaObjective 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.https://bmjophth.bmj.com/content/9/1/e001910.full |
| spellingShingle | Waleed T Batais Nada O Taher Abeer K Alhindi Abdullah A Ghaddaf Anas Alamoudi Sarah A Al-Ghamdi Jumanah J Homsi Hashem S Almarzouki Mansour A Qurashi Efficacy and Safety of Prophylactic Agents in Prevention of Retinopathy of Prematurity: A Systematic Review and Meta-analysis of Randomised Controlled Trials BMJ Open Ophthalmology |
| title | Efficacy and Safety of Prophylactic Agents in Prevention of Retinopathy of Prematurity: A Systematic Review and Meta-analysis of Randomised Controlled Trials |
| title_full | Efficacy and Safety of Prophylactic Agents in Prevention of Retinopathy of Prematurity: A Systematic Review and Meta-analysis of Randomised Controlled Trials |
| title_fullStr | Efficacy and Safety of Prophylactic Agents in Prevention of Retinopathy of Prematurity: A Systematic Review and Meta-analysis of Randomised Controlled Trials |
| title_full_unstemmed | Efficacy and Safety of Prophylactic Agents in Prevention of Retinopathy of Prematurity: A Systematic Review and Meta-analysis of Randomised Controlled Trials |
| title_short | Efficacy and Safety of Prophylactic Agents in Prevention of Retinopathy of Prematurity: A Systematic Review and Meta-analysis of Randomised Controlled Trials |
| title_sort | efficacy and safety of prophylactic agents in prevention of retinopathy of prematurity a systematic review and meta analysis of randomised controlled trials |
| url | https://bmjophth.bmj.com/content/9/1/e001910.full |
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