The effect of sildenafil on retinopathy of prematurity in very preterm infants

Objective: Sildenafil is occasionally used as rescue treatment for preterm infants with severe bronchopulmonaiy dysplasia and pulmonary arterial hypertension. In adults, sildenafil treatment has been associated with several ophthalmological adverse effects, including nonarteritic ischaemic optic neuropathy. We reviewed the effect of sildenafil on retinopathy of prematurity (ROP) in very preterm infants. Study Design: Retrospective case control study. Infants born <30 weeks gestation who had received sildenafil during their hospitalisation were included. A control group matched for gestation, birth weight, gender, and place of birth was identified from the departmental database. For every sildenafil case, three matched controls were studied. Baseline data, sildenafil therapy data, results of eye examinations and respiratory data were analysed. Result: 17 infants received sildenafil between 2004 and 2010. The median duration of sildenafil treatment was 52 days. Baseline characteristics were similar between groups. The odds ratio for an increase in ROP stage in the group treated with sildenafil was 1.35 (95% confidence interval 0.39-4.62, P-value 0.63). One infant in each group required laser treatment. Conclusion: Sildenafil treatment did not affect ROP progression or increase the need for laser treatment in this cohort. Journal of Perinatology (2013) 33, 218-221; doi:10.10384.2012.84; published online 5 July 2012