Red light (670nm) treatment to prevent retinopathy of prematurity (ROP)

Retinopathy of prematurity is a common complication of very premature delivery (less than 30 weeks gestation) and without appropriate screening and treatment can lead to retinal detachment and blindness. It is the leading cause of blindness in children. While in the uterus the fetus and the retina is developing in an environment where the partial pressure of oxygen is only 25-35 mmHg. Following premature delivery the retina is then exposed to partial pressures of oxygen of 60 mmHg and above. ROP has been shown to occur as a result of this hyperoxic exposure, and despite tight control on oxygen saturations which has led to a significant reduction in the disease, ROP still occurs in some part due to the fact that the retina is not meant to develop in this hyperoxic environment. Exacerbating this situation is that many of the neonates at most risk of ROP have significant lung disease of prematurity and as a consequence have recurrent episodes of hyper and hypoxia which occur despite attempts at tight control of oxygen delivery. 670nm red light is thought to act on the cytochrome c oxidative pathway (within cells of the body), which reduces the presence and production of oxygen free radicals. 670nm red light has been shown to reduce ROP in a mice and rat animal model. It has been used safely in the treatment of soft tissue injuries and mouth ulcers following radiation treatment and studies are ongoing with its use in diabetic retinopathy and age-related macular degeneration. This study aims to look at whether 670nm red light reduces the incidence of any stage of ROP and the incidence of ROP requiring laser surgery.