Br J Ophthalmol 1999;83:425-428 ( April )
Dopamine use is an indicator for the development of threshold
retinopathy of prematurity
Michael B Mizoguchi,a
Thomas G Chu,a
Frederick M Murphy,c
Neil Willits,b
Lawrence S Morsea
a Department of
Ophthalmology, University of California at Davis, Sacramento, CA, USA, b Department of Statistics, University of
California at Davis, Sacramento, CA, USA, c Department of Pediatrics, Doctors Medical
Center, Modesto, CA, USA
Correspondence to: Lawrence S Morse, MD, Department of Ophthalmology, University
of California at Davis, 4860 Y Street, Sacramento, CA 95817, USA.
Accepted for publication 30 September 1998
AIM
To assess whether
treatment of premature infants with dopamine is a risk factor for
development of retinopathy of prematurity (ROP).
METHODSA
retrospective case series analysis of two groups was utilised with a
minimum follow up of 6 months. Clinical profiles and patient risk
factors were identified along with an evaluation of ROP progression and
an analysis of clinical outcome. All infants were seen in a single
community neonatal intensive care unit (NICU). 41 consecutive high risk
infants were identified during a 36 month period whose birth weight was
less than 1000 grams and who remained in the NICU without transfer
until at least 28 days of age. Dilated indirect ophthalmoscopy fundus
examinations were performed on all infants to identify the degree of
and progression to threshold ROP.
RESULTS18 of 41 infants were treated with dopamine for hypotension. The group of
infants requiring dopamine differed statistically from the non-dopamine
treated group by having a slightly higher birth weight, a greater
incidence of hypotension and colloid treatment, and in manifesting more
advanced respiratory disease. Within the dopamine treated group, 12 of
18 infants (67%) reached prethreshold ROP and seven infants (39%)
reached threshold ROP requiring laser treatment. In contrast, only
three of the infants (13%) who did not require dopamine for
hypotension progressed to prethreshold (p=0.001) and only one of these
infants (4%) progressed to threshold ROP (p = 0.02). Logistic
regression analysis among other variables demonstrated that dopamine
use and gestational age are important factors in this low birthweight
population for predicting the development of threshold ROP (dopamine
use: adjusted odds ratio = 119.88, p = 0.0061; gestational age:
adjusted odds ratio = 0.061, p = 0.0043).
CONCLUSIONSDopamine
use in low birthweight infants may therefore be a risk factor for the
development of threshold ROP. More vigilant screening of high risk
infants requiring dopamine therapy for systemic hypotension may be warranted.
Keywords:
dopamine;
retinopathy of
prematurity;
infants
© 1999 by British Journal of Ophthalmology
