Retinopathy of Prematurity Clinical Trial
Official title:
Safety and Efficacy of Propranolol Treatment in Newborns With Retinopathy of Prematurity:a Prospective Cohort Study
The purpose of this study is to evaluate the safety and efficacy of oral/local propranolol in preterm newborns who diagnosed as early phase of retinopathy of prematurity (ROP).
The incidence of Retinopathy of Prematurity (ROP) in preterm newborns less than 1500g is
about 60% in the developed countries around the world, while there are much more preterm
newborns more than 1500g and 32 weeks gestational age with Retinopathy of Prematurity (ROP)
had to be treated in the developing countries. ROP has listed top of the five causes lead to
blindness in children, which seriously threated children's vision and quality of life.
The ablation of the retina with photocoagulation by laser or cryotherapy reduces the
incidence of blindness by suppressing the neovascular phase of ROP. However, those Surgeries
require anesthesia and some of them may result in complications such as apnea, neonatal
necrotizing enterocolitis, sepsis, and hemorrhage of digestive tract. As a result, it's
important to study an alternative non-surgical treatment method.
The development of ROP depends largely from vascular endothelial growth factor (VEGF). The
reduction of VEGF expression in the neovascular phase might prevent destructive
neovascularization in ROP.
Propranolol is a kind of beta-adrenergic receptor (β-AR) which can inhibit the expression of
VEGF and has been first choice of treating infantile hemangioma, the most common tumor of
infancy. There are some pilot studies suggesting that the administration of oral propranolol
is effective in counteracting the progression of ROP in patients without operation
indication. Nevertheless that safety is a concern, for oral propranolol may result in
associated complications and side effects such as bradycardia, hypotension, injury of
cerebrum growth and olfactory.
Recently a research of eye drop propranolol in a mouse model of oxygen-induced retinopathy
(OIR) has shown that propranolol was still effective in inhibiting angiogenic processes,
indicating that local administration is equally effective.
The purpose of this study is to evaluate safety and efficacy of oral/local propranolol in
preterm newborns with early phase of retinopathy of prematurity (ROP).The study will be
followed up for a period of time, observing the development of optic and nerve system
complications to further confirm the efficacy of propranolol to ROP treatment, which can
provide theoretical basis for the futher clinical application of the drug in ROP.
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