Assessment of the contribution of cytokine plasma levels to detect retinopathy of prematurity in very low birth weight infants.

PURPOSE

To prospectively study the association of high cytokine plasma levels with later development of retinopathy of prematurity (ROP) in preterm infants with early-onset sepsis to assess a laboratory test to detect ROP.

METHODS

A prospective cohort study was conducted of preterm infants with clinical early-onset sepsis whose birth weight (BW) was ≤1500 g and gestational age (GA) was ≤32 weeks. Plasma samples were assayed for cytokines IL-6, IL-8, IL-10, IL-1β, and TNF-α. ROP was diagnosed in screening assessments. For the univariate analysis of the known risk factors for ROP, all infants without ROP were designated as the No ROP group, patients with any stage of ROP formed the ROP group, and all treated patients formed the Severe ROP group. The best cutoff points for all cytokine levels were determined by ROC curves.

RESULTS

Seventy-four patients were enrolled. Mean GA and BW were 29.6 ± 2.1 weeks and 1110.3 ± 232.5 g, respectively; 49 patients (66.2%) had no ROP and 25 (33.8%) had any stage of ROP (17 had stage 1 or 2 ROP and 8 had stage 3 ROP). IL-6 >357 pg/mL, IL-8 >216 pg/mL, and TNF-α >245 pg/mL were significantly associated with treatable ROP.

CONCLUSIONS

There is a relationship between high plasma levels of IL-6, IL-8, and TNF-α in the first days of life with the later development of ROP severe enough to treat in preterm infants with early-onset sepsis. Further epidemiologic studies are needed to explore other possible associations of high serum levels of cytokines with ROP in this population at high risk.