Steroid eye drops may mitigate effects of retinopathy of prematurity

Researchers from Lund University in Sweden have highlighted the potential of steroid eye drops for mitigating the effects of retinopathy of prematurity (ROP).

Writing in Ophthalmology, the authors highlighted that treating preterm infants with daily cortisone eye drops reduced the chances that they would require traditional treatments, such as laser ablation or intravitreal injections of anti–VEGF.

“A timely administration of low-dose dexamethasone eye drops may serve as a simple, cost-effective, and non-invasive intervention to reduce one of the leading causes of severe visual impairment worldwide,” the authors highlighted.

Lund University project manager for the retinopathy of prematurity research team, Lotta Gränse, shared that she came up with the idea for the study after observing that eye inflammation subsided in preterm babies who received cortisone eye drops before laser therapy.

“This sparked the idea of starting to administer a lower dose of cortisone drops at an earlier stage before the disease had progressed too far,” she said.

“It was absolutely fantastic to see how babies who previously used to get worse and undergo destructive laser surgery, now, with usually only one drop of cortisone a day, sailed past that treatment and healed. It seemed inconceivable that no one had thought of introducing cortisone drops before,” Gränse highlighted.

Between 2020 and 2021, cortisone drops were administered to babies born before 30 weeks gestation with severe ROP in the Southern Healthcare Region in Sweden.

Over the study period, only 13% of babies required conventional treatment – compared to 72% of babies in the period preceding the intervention (2015–2018).

Researchers also examined data from three other hospitals that continued with standard protocols. They found that 47% of babies with severe ROP required conventional treatment between 2015 and 2018.

This continued relatively unchanged in 2020 and 2021, when 56% of babies with severe ROP required conventional treatment.

Gränse, who is a senior ophthalmology consultant at Skåne University Hospital, highlighted that the new treatment protocol makes economic sense as well as being positive for individuals.

“It makes a huge difference for the children affected and their families, but also in socio-economic terms. Cortisone drops are inexpensive, whereas surgery is very resource-intensive,” she said.