Reducing the medication dosage when screening premature babies for retinopathy of prematurity

Premature babies are screened to check for the presence and severity of retinopathy of prematurity. This includes eye examinations that require the use of pupil-dilating medications. With Cure Kids support, Dr Reith is trialling whether lower dosages of the medications used will dilate the pupil enough. This study has the potential to inform treatment guidelines for screening premature babies.

Associate Professor David Reith

University of Otago

In New Zealand and Australia, around 540 very premature babies are born each year. These babies are at high risk for many health issues including blindness caused by retinopathy of prematurity (ROP). ROP is an eye disease that causes abnormal blood vessels to grow in the retina and is one of the most common causes of visual loss in childhood. Although this is a serious condition, it can be treated with early intervention.

Premature babies are screened to check for the presence and severity of ROP. This includes several eye examinations that require the use of pupil-dilating medications, many of which have adverse side-effects.

Trialling lower dosages of medications for pupil dilation

Dr Reith and his team are trialling whether lower dosages of the medications (phenylephrine and cyclopentolate) will effectively dilate the pupil.

Dr David Reith and PhD student Lisa Kremer, from the University of Otago, have found inconsistencies in best-practice for pupil-dilation dosage, with some hospitals using higher doses in babies than what is used in adults. To inform better practice, Dr Reith and his team are trialling whether lower dosages of the medications (phenylephrine and cyclopentolate) will effectively dilate the pupil to give ophthalmologists a good view of the retina.

A randomised control trial will take place in Dunedin, Wellington and Christchurch in 150 premature babies. The babies will be randomised to receive a lower or higher dose of phenylephrine and cyclopentolate. The team will assess the effects of the different dosages on dilating the pupil, as well as monitoring for adverse side-effects.

This Cure Kids-funded study could answer important questions on the effectiveness of different eye-drop regimens when screening premature babies for ROP. It has the potential to inform guidelines in New Zealand and internationally, improving health outcomes for vulnerable babies.