Propranolol Shows Efficacy in Reducing the Risk of ROP Progression

While there are many published studies regarding the use of oral propranolol for prevention of retinopathy of prematurity (ROP), there is no general consensus on the advantages and risks of this therapy.

Study Design

Investigators conducted a systematic literature and meta-analysis to gather the currently available evidence for oral propranolol in ROP prevention in premature infants (gestational age <34 weeks). Eight randomized controlled studies published before August 2020, when the literature search was run, met the inclusion criteria. The primary outcome was ROP progression; secondary outcomes included the effect of propranolol on the delivery of laser and anti-VEGF treatment for ROP.

Outcomes

In general, propranolol was found to decrease the risk of ROP disease progression (RR 0.59) and the risk of plus disease (RR 0.42) compared with placebo (controls). Propranolol also decreased the need for laser photocoagulation and intravitreal anti-VEGF therapy.

Limitations

There were differences in study design between the 8 studies. The dosage and timing of propranolol administration for ROP have yet to be completely defined. Furthermore, there was incomplete reporting of propranolol-related systemic adverse events, which need to be considered if employing this treatment.

Clinical Significance

Propranolol may be effective in decreasing the progression of ROP, thereby preventing visual complications. However, further research, conducted among diverse populations, needs to be done regarding the dosage and timing of treatment as well as systemic side effects.

Financial Disclosures: Dr. Brenda Bohnsack discloses no financial relationships.