Evidence-based review of retinopathy of prematurity prevention in VLBW and ELBW infants.

Retinopathy of prematurity (ROP) continues to be a significant complication in preterm neonates despite advances in neonatal care. Very low birth weight and extremely low birth weight infants continue to suffer from the sequelae of premature birth, including ROP. Controversy and uncertainty surround prevention of ROP. Possible preventive strategies include the use or restriction of oxygen therapy; steroid therapy; changes in blood transfusion protocols; reduced exposure of the retina to light; and administration of nutritional factors, indomethacin, and D-penicillamine. This article reviews recent studies that have proved or disproved the effectiveness of these preventive measures. It also identifies the implications of the study results for clinical practice and makes recommendations for future research.