Childhood ocular safety after postnatal exposure to topical dexamethasone during retinopathy of prematurity screening
Mariya Petrishka‐Lozenska, Anders K. Nilsson, Ann Hellström, Pia LundgrenAbstract
Purpose
Dexamethasone eye drops are being introduced off‐label to prevent progression of severe retinopathy of prematurity (ROP). We evaluated ophthalmologic outcomes in early childhood after postnatal topical dexamethasone exposure in pre‐term infants at a standardized follow‐up examination.
Methods
This prospective cross‐sectional follow‐up study included preterm infants born between 2019 and 2022 in the Västra Götaland region, Sweden, who received topical dexamethasone off‐label during ROP screening. As a follow‐up, a single standardized ophthalmological examination assessed visual acuity, refractive error, ocular motility, intraocular pressure (IOP) and structural ocular abnormalities.
Results
Twenty‐four infants (median gestational age 25.0 weeks, range 22.6–27.7 weeks; 58% male) were examined at a median age of 2.9 years (range 1.1–5.0 years). Dexamethasone eye drops were initiated mainly for severe ROP at a median postmenstrual age of 35.1 weeks (range 32.0–52.0 weeks) and given for a median duration of 28 days (range 4–136 days). Median IOP was 18.9 mmHg (range 9.0–22.3 mmHg), and no child showed clinical signs of glaucoma. One child had a unilateral peripheral lens opacity without visual significance. No other ocular structural abnormalities were detected. Strabismus was detected in 2 (8%) of the children, and 3 (12%) had refractive errors.
Conclusion
Preliminary data from extremely preterm infants exposed to off‐label topical dexamethasone during ROP screening showed no clinically significant ocular adverse effects at standardized early childhood follow‐up. Rates of strabismus and refractive errors were lower than expected. Larger studies with longer follow‐up are needed to further assess ocular and systemic safety.