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Comment & Response
July 11, 2019

Oxygen Saturation in Infants With Retinopathy of Prematurity—Reply

Author Affiliations
  • 1Division of Neonatology, Department of Pediatrics, Cleveland Clinic, Cleveland, Ohio
  • 2Department of Pediatrics, Metro Health Medical Center, Case Western Reserve Institute, Cleveland, Ohio
  • 3Division of Ophthalmology, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio
  • 4Cellular and Molecular Medicine, Cleveland Clinic, Cleveland, Ohio
JAMA Ophthalmol. 2019;137(9):1092. doi:10.1001/jamaophthalmol.2019.2558

In Reply We are grateful for the thoughtful question. Caffeine therapy is one of the well-studied and effective treatments for apnea of prematurity. Yet there exists a wide variation in clinical practice with regard to the timing, dosage, and discontinuation of this medication. In our study,1 we did not evaluate apnea incidence or its treatment with caffeine. Owing to the lack in consensus on the accurate method, as well as the subjective variability in assessing events (such as the number of apnea episodes per day, seconds of apnea, and associated bradycardia and desaturation), we did not collect these data.2-4 Additionally, the length of therapy with caffeine is largely based on the administering clinician’s choice and does not have a strict protocol for discontinuation at the study institution.5 Thus, it would be very difficult to retrospectively make an inference of the association of different oxygen levels with those outcome measures. We agree that this would be a very interesting association to study in the future.