Caffeine Therapy Reduces Severe Retinopathy of Prematurity in Neonates with Gestational Age between 23 and 28 Weeks.

Purpose: To investigate the association of caffeine citrate therapy with the onset and exacerbation of retinopathy of prematurity (ROP). Design: A retrospective observational cohort study. Participants: Preterm neonates born at Hyogo Prefectural Amagasaki General Medical Center between January 2018 and December 2023 were included. Methods: Data on maternal (age; comorbid hypertensive disorders of pregnancy and gestational diabetes mellitus; fetal growth restriction; and cesarean section) and neonatal (sex; gestational age; birth weight; zone at initial examination; Apgar scores; respiratory distress syndrome; chronic lung disease; tracheal intubation; duration of tracheal intubation; duration of oxygen therapy; and caffeine therapy) risk factors for ROP were collected from medical records. Main Outcome Measures: Retinopathy of prematurity onset and severe ROP were defined as stage ≥1 and stage ≥3 during the course of follow-up, respectively. The association between caffeine therapy and the onset of any ROP and severe ROP was investigated. Results: Among 202 neonates included in the current study, 94 (46.5%) developed any ROP (stage ≥1) during the observational period. Only the zone at initial examination affected the onset of any ROP ( Conclusions: Caffeine therapy may be a potential treatment strategy to prevent the progression of severe ROP in neonates born between 23 and 28 weeks' gestational age. Financial Disclosures: The authors have no proprietary or commercial interest in any materials discussed in this article.