Japanese researchers found caffeine therapy may be a potential treatment strategy to prevent the progression of severe retinopathy of prematurity (ROP) in neonates born between 23 and 28 weeks' gestational age.

Writing in Ophthalmology Science, the Hyogo Prefectural Amagasaki General Medical Center team analysed 202 preterm neonates, defining any ROP as stage 1 or higher during follow-up and severe ROP as stage 3 or higher. Overall, 94 neonates (46.5%) developed any ROP and only the zone at initial examination was associated with onset of any ROP.

Among 115 neonates born at under 32 weeks’ gestation and weighing under 1.5kg, larger zones at baseline and caffeine treatment were associated with decreased severe ROP. In the subgroup of 54 neonates born at 23–28 weeks, caffeine therapy was the only factor associated with decreased development of severe ROP. Their analysis also showed a significant difference in severe ROP incidence between those treated with caffeine and those not treated.

All four neonates born before 23 weeks progressed to severe disease, despite caffeine treatment.