Safety and Efficacy of Propranolol in Newborns With Retinopathy of Prematurity

Retinopathy of Prematurity (ROP) is still a major cause of blindness in children in developed countries around the world, and an increasing cause of blindness in developing countries. The ablation of the retina with photocoagulation by laser or cryotherapy reduces the incidence of blindness by suppressing the neovascular phase of ROP. However, the visual outcomes after treatment are often poor. The development of ROP depends largely from vascular endothelial growth factor (VEGF). The reduction of VEGF expression in the neovascular phase might prevent destructive neovascularization in ROP.

The purpose of this study is to evaluate whether the administration of propranolol is safe and is able to reduce the incidence of blindness by suppressing the neovascular phase of ROP compared to a control group receiving conventional laser therapy.

Inclusion criteria

• Infants who have been screened for ROP (≤ 32 weeks gestation) who develop Stage 2 ROP in zone II without plus.
• Informed Consent from a parent

Exclusion criteria

• Newborns with one or more of the following conditions at the enrollment in the study:

• Heart failure.
• Recurrent episodes of bradycardia (Heart rate less than 90 bpm).
• Atrio-ventricular block (second or third degree).
• Significant congenital heart anomaly, not including patent ductus arteriosus, patent foramen ovale or small ventricular septal defect.
• Hypotension.
• Renal failure.
• Cerebral hemorrhage.
• Other diseases which contraindicate the use of beta-blockers
• Newborns with ROP stages more advances than Stage 2 in zone II without plus.
• Informed Consent from a parent refused. This will mean that an infant automatically will receive standard laser therapy. No data will be used from an infant without Informed Consent.