UT-Houston Coordinates National Study to Prevent Blindness in Smallest Infants

A new approach to a potentially blinding eye disorder that strikes low-birthweight babies is being tested in a national research project coordinated from The University of Texas-Houston Health Science Center School of Public Health.

The five-year project funded by a $9.7-million grant from the National Eye Institute to Dr. Robert Hardy, professor of biometry, will examine the value of earlier laser or cryotherapy treatment for retinopathy of prematurity (ROP).

Doctors in 25 centers across the country will employ a risk analysis computer program developed by Dr. Hardy and his colleagues to decide when to treat infants with the disorder, which causes abnormal growth of blood vessels into the retina and nerve tissue in the back of the eye. ROP can cause retinal scarring or detachment, leading to blindness.

It is a particularly challenging disorder because its causes are unclear, Dr. Hardy notes, and in the majority of cases, ROP goes away untreated. This provides a sound reason to delay treatment, which involves laser or cryotherapy surgery around the eye's periphery, but research shows that waiting too long increases the risk of blindness in high-risk babies.

How do you identify the high-risk children for early treatment and at the same time minimize the possibility of performing unnecessary surgery? Dr. Hardy and colleagues Charles Cooper and Betty Tung developed a computerized risk management analysis program, called RM-ROP2, using data from a 1993 study coordinated by Dr. Hardy that examined the effectiveness of cryosurgery for ROP.

"The program uses a number of risk factors such as birth weight, gestational age, location of ROP in the retina and stage of the disease to calculate the probability of an eye having an unfavorable outcome," Dr. Hardy says.

Pediatric ophthalmologists in the study will use the computer program to track the progress of ROP in their tiny patients. If treatment is warranted, researchers will call Dr. Hardy's team and they will verify the child's risk rating and then tell the doctor which eye to treat. The other eye will be treated conventionally at the disease's more advanced level if the disease progresses.

Dr. Hardy will work closely with Dr. William Good at Smith-Kettlewell Eye Institute in San Francisco to carry out the study involving more than 4,000 infants with ROP. About 400 babies are expected to receive the earlier treatment.

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©2006 Texas Medical Center

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