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TOPLINE:

Early high-dose recombinant human erythropoietin (rhEPO) in preterm infants influences macular vessel density (VD) parameters without contraindicating its use for macular development.

METHODOLOGY:

• The study focused on children who were born between 26 and 31 weeks gestation (mean age, 11 years) from an ongoing neuropediatric study who were randomly assigned to receive either rhEPO (3000 IU/kg) or placebo (isotonic saline, 0.9%) within 3 hours of birth.
• Researchers utilized optical coherence tomography (OCT) and OCT angiography to analyze the long-term effects of rhEPO on vascular and macular structural characteristics.
• A total of 87 children were enrolled and examined, with 52 receiving the intervention and 35 receiving placebo, alongside 52 children born full term in the healthy control group.
• Outcome measures included central retinal thickness, total macular volume, grade of foveal hypoplasia, foveal avascular zone, VD, and vessel length density (VLD).

TAKEAWAY:

• VD and VLD were significantly lower in the rhEPO group than in the placebo, indicating a distinct impact on vascular development (P = .015 for both).
• The proportion of any grade of foveal hypoplasia was notably higher in the erythropoietin group than in the placebo and control groups (31.4% vs 15.2% vs 6%), suggesting an influence of the drug on macular structure.
• The mean foveal avascular zone area differed across groups, being the smallest in the erythropoietin group (0.14 mm²) and the largest in the healthy control group (0.24 mm²).

IN PRACTICE:

"We have documented an impact of early high-dose rhEPO on macular vessel density parameters, while the other structural parameters were unchanged. Further studies are needed to understand the complex role of rhEPO on macular vascular development and its clinical significance," wrote the authors of the study.

SOURCE:

The study was led by Brida M. Jeltsch, of the Department of Ophthalmology at the University Hospital Zurich and the University of Zurich in Zurich, Switzerland. It was published online on June 14 in the American Journal of Ophthalmology.

LIMITATIONS:

The sample size and the demographics of preterm infants may limit the generalizability of the findings to a broader population. The long-term effects of erythropoietin on macular development beyond the age range studied (7-15 years) remain unclear. The study design also did not account for potential confounding factors that could influence macular development independently of drug administration.

DISCLOSURES:

The study was supported by the Bruppacher Stiftung and OPOS Stiftung, Switzerland. Hanson received additional support from the Velux Stiftung. Jonas Fuglistaler is employed by Genedata, unrelated to this work.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.