Abstract 1281

With increased survival of the extremely low birthweight (ELBW) infants we have noticed an increased incidence in the severity of ROP. In spite of the sophisticated oxygen monitoring and assisted ventilation methods available in our NICU we are seeing a high incidence of detached retina and blindness. Our ROP screening starts at 4-6 weeks and is repeated according to our ROP protocol based on national standards. These infants are followed in our Premature Clinic with a retinal specialist. During 1993-1996, 376 infants with birthweight ≤1500 grams survived of whom 175 infants developed ROP. Seventy-six infants developed ROP stage 3 and of those 28 infants progressed to detached retina and blindness in spite of laser treatment. Objective: To determine differences within the group of infants who developed ROP stage 3 and regressed from those who developed stage 3 and progressed to stage 4-5. Methods: Two groups were identified. Group 1: 48 infants with regressed ROP stage 3, group 2: 28 infants who progressed to stage 4-5. Seventy maternal and neonatal variables were evaluated. Statistics: Chi square and unpaired t test. Results: Group 1 had a mean GA of 26 wks (SD 1.9), range 22-30 wks and a mean birthweight of 795 gms (182), range from 465-1265 gms. Forty percent were males, 92% were Hispanics. Group 2 had a mean GA of 24 wks (2.1), range 22-29 wks and a mean birthweight of 643 gms(154), range 430-1070. Forty-three percent were males, 86% were Hispanics. Significant factors that differentiate group 2 from group 1 were: Lower GA and BW (p <.001), less days of breastmilk feedings while in the NICU (p<.001), need for treatment with indocin (p<.05) or amphotericin (p<.01), fewer mothers treated with prenatal betamethasone (p<.05). There was also a trend for increased severity of ROP with a lack of prenatal care (p=.05). Length of ventilator care, oxygen therapy, TPN, phototherapy, and highest level of bilirubin, first pH, PCO2, and PO2, blood pressure changes and infant use of dexamethasone were not significant. Conclusions: The ELBW infants are at highest risk of developing severe ROP and blindness and this increases with decreasing birthweight and gestational age. This information should be shared and discussed when counseling parents. The possibility exists that nutritional factors in breast milk may be favorable in protecting these infants. Further nutritional studies are suggested.