A controlled clinical trial of light and retinopathy of prematurity.

Bright continuous light has been implicated in the pathogenesis of retinopathy of prematurity. To investigate the influence of light on the incidence and severity of retinopathy of prematurity, we enrolled 127 preterm infants (birth weight < or = 1,500 g; gestational age < or = 32 weeks) in a controlled clinical study. Randomization was done separately for three birth-weight groups (< 1,000 g; 1,000 to 1,249 g; 1,250 to 1,500 g). The babies' eyes were patched all day and night from birth to a gestational age of 35 weeks. The infants in the control group were exposed to cycled lighting conditions (that is, reduced light level during the night). Of 62 infants with patched eyes, 26 (42%) developed retinopathy of prematurity. In the control group, 25 of 65 infants (39%) showed retinopathy of prematurity (P = .596). There were also no statistically significant differences in the incidences of retinopathy of prematurity in the birth-weight subgroups or in the severity of retinopathy of prematurity. Thus, patching of the eyes from birth to 35 weeks of postconceptional age does not decrease the risk of retinopathy of prematurity in preterm infants when compared to a control group exposed to cycled lighting conditions.

[1]  T. L. Terry FIBROBLASTIC OVERGROWTH OF PERSISTENT TUNICA VASCULOSA LENTIS IN PREMATURE INFANTS: IV. ETIOLOGIC FACTORS , 1943 .

[2]  C. Timms,et al.  Clinical evidence for the onset of the sensitive period in infancy. , 1992, The British journal of ophthalmology.

[3]  A. B. Reese,et al.  Retrolental fibroplasia; the negative role of light, mydriatrics, and the ophthalmoscopic examination in its etiology. , 1952, A.M.A. archives of ophthalmology.

[4]  D. Hubel,et al.  Comparison of the effects of unilateral and bilateral eye closure on cortical unit responses in kittens. , 1965, Journal of neurophysiology.

[5]  D. Friendly,et al.  Effect of bright light in the hospital nursery on the incidence of retinopathy of prematurity. , 1985, The New England journal of medicine.

[6]  B Ackerman,et al.  Reduced incidental light exposure: effect on the development of retinopathy of prematurity in low birth weight infants. , 1989, Pediatrics.

[7]  A. Fielder,et al.  Light and retinopathy of prematurity: does retinal location offer a clue? , 1992, Pediatrics.

[8]  J. Lanum,et al.  The damaging effects of light on the retina. Empirical findings, theoretical and practical implications. , 1978, Survey of ophthalmology.

[9]  E. Stefánsson Retinal oxygen tension is higher in light than dark. , 1988, Pediatric research.

[10]  T. Hirose,et al.  An International Classification of Retinopathy of Prematurity: II. The Classification of Retinal Detachment , 1987 .

[11]  G. Quinn,et al.  Onset of retinopathy of prematurity as related to postnatal and postconceptional age. , 1992, The British journal of ophthalmology.

[12]  G. Turkewitz,et al.  Bright light and retinopathy of prematurity. , 1986, The New England journal of medicine.

[13]  T. L. Terry Extreme Prematurity and Fibroblastic Overgrowth of Persistent Vascular Sheath Behind Each Crystalline Lens* : I. Preliminary Report , 1942 .

[14]  J. Weiter,et al.  Response of human retinal blood flow to light and dark. , 1983, Investigative ophthalmology & visual science.

[15]  A. Krause,et al.  Retrolental fibroplasia and light. , 1949, Pediatrics.