Findings in 170 ≤ 1000g BW, ≤ 32 wks GA infants born at PAH from Jan 1991 to Nov 1997 are reported. ROP screening was initiated at age one month and continued at 1 to 2 week intervals until retinal vascular maturity, regression of ROP or cicatricial ROP was noted. All infants were maintained on E prophylaxis (target serum levels 1 to 3 mg/dl) started within 12 hours of birth using standard vitamin preparations. E levels were monitored weekly and pharmacologic Rx (target serum levels 4 to 5 mg/dl) with oral Aquasol E or Hoffmann LaRoche IND parenteral free E alcohol, was started for prethreshold or threshold ROP (n=16). Ten infants were transferred at ≤ 28 days for surgical or congenital problems (x GA 26.6 wks + 1.7 SD) and did not return to PAH. Of these, five (GA 25-30 wks) died soon after transfer; two (GA 25 & 29 wks) had laserRx for threshold ROP with subsequent retinal detachment; one had prethreshold ROP with macular heterotopia and high myopia. E levels were not monitored at these hospitals. 160 infants (xBW 801g±139; x GA 26.5 wks±2.0; x hospital stay 96 days±36) were cared for at PAH and had adequate monitoring for ROP. All had normal posterior retinal structure on follow-up, including three who had threshold ROP and laser Rx. (See Table) Conclusions: The low incidence of both threshold ROP and its visual sequelae in ≤1000g BW infants support our earlier findings (J Peds 1995;127:632) in 450 ≤ 1250g BW infants (born'85-91) in whom visual outcome after threshold ROP (n=33) with cryoRx was significantly better than in cryoRx infants in the 1986-87 CRYO-ROP CCT. Since visual sequelae of ROP remain a problem in ≤1000g BW infants, the promising results of the PAH vitamin E protocol should be tested in a large CTT.

Table 1 No caption available.
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