Propranolol Shows Promise in Preventing Severe Retinopathy of Prematurity

Retinopathy of prematurity (ROP) remains a leading cause of avoidable blindness in infants, particularly among extremely preterm newborns. With the rising survival rates of these infants, the incidence of ROP has increased, emphasizing the need for effective preventive strategies.

A recent meta-analysis delved into the potential of propranolol as a therapeutic option and early prevention method for ROP, shedding light on its effectiveness.This study was published in American Journal Of Ophthalmology by Shafique M. and colleagues.

A comprehensive meta-analysis, encompassing 8 relevant studies, was conducted to assess the efficacy of propranolol in preventing severe ROP. Following rigorous evaluation using PRISMA guidelines, the analysis included trials and observational studies involving beta-blockade to prevent stage ≥3 ROP or treatment requirement.

The meta-analysis revealed compelling evidence supporting the use of oral propranolol as a preventive measure for severe ROP. The Risk Ratio of 0.59 indicated a significantly lower risk of ROP development compared to other therapies or control groups.

Risk Ratio for plus disease: 0.42 (95% CI 0.23, 0.78; P= 0.006, I2= 0%)

Risk Ratio for laser photocoagulation: 0.48 (95% CI 0.31, 0.74; P= 0.001; I2= 2%)

Risk Ratio for intravitreal injection of VEGF: 0.43 (95% CI 0.24, 0.74; P= 0.003, I2= 0%)

These figures suggest a substantial reduction in the likelihood of developing plus disease or requiring laser photocoagulation or intravitreal VEGF injection for ROP in infants treated with propranolol.

The findings of this meta-analysis present promising implications for the use of oral propranolol as a preventive measure against severe ROP in premature newborns. However, the appropriate dosage and timing of propranolol administration warrant further investigation as they can significantly impact treatment outcomes.

The success of propranolol in preventing severe ROP underscores the importance of continued research in refining its administration protocols. Future studies should focus on optimizing dosage regimens and timing to maximize treatment efficacy and safety for this vulnerable population.

Reference:

Shafique, M. A., Haseeb, A., Uddin, M. M. N., Asghar, B., Chaudhry, E. R., Raqib, M. A., Ali, S. M. S., & Mustafa, M. S. Effectiveness of propranolol in preventing severe retinopathy of prematurity: A comprehensive systematic review and meta-analysis. American Journal of Ophthalmology,2023. https://doi.org/10.1016/j.ajo.2023.11.012