Light Reduction by Opaque Goggles Does Not Prevent Retinopathy of Premature Infants

Source: Reynolds JD, et al. Lack of efficacy of light reduction in preventing retinopathy of prematurity. N Engl J Med 1998;338:1572-1576.

Hospital-nursery lighting has been suggested as a factor in causing retinopathy of prematurity, but a causal relation has not been established. Reynolds and colleagues in the National Light Reduction of Prematurity Cooperative Group conducted a prospective, randomized, multi-center study of the effects of light reduction on 409 premature infants with birth weights of less than 1251 g and gestational ages of younger than 31 weeks. Two hundred five infants were exposed to reduced light, and 204 to typical nursery lighting. The amount of light reaching the infants' eyes was reduced within 24 hours after birth by placing goggles on the infants that reduced visible-light exposure by 97% and ultraviolet-light exposure by 100%. The babies wore the goggles until 31 weeks postconceptional age or four weeks after birth. When the goggles were removed, ophthalmologists unaware of the treatment assignments assessed the infants for retinopathy of prematurity at least biweekly for up to 13 weeks.

There were 188 infants in the group that wore goggles and 173 in the control group who survived and were available for follow-up. The mean birth weights were 906 g in the goggles group and 914 g in the control group. Retinopathy of prematurity was diagnosed in 102 infants (54%) in the goggles group and 100 (58%) in the goggles group and 100 (58%) in the control group (relative risk, 0.95%; confidence interval, 0.8-1.1; P = 0.50).

A reduction of ambient light exposure by use of goggles in small, premature infants did not change the incidence of retinopathy of prematurity.-rae