Caffeine Therapy Role in Reducing ROP Progression

Caffeine citrate is often administered to preterm neonates in the hospital for apnoea of prematurity or extubation support.  

The observational cohort study included 202 preterm neonates with a gestational age of less than 36 weeks or a birth weight of less than 3 kg, born between 2018 and 2023.  

… caffeine therapy may be a potential treatment for preventing the progression of severe ROP in neonates

Particular attention was paid to the association between caffeine citrate therapy and ROP outcomes. 

Study authors said the results “demonstrated an association between caffeine therapy and decreased severe ROP”.  

“The time to proliferation was longer in neonates treated with caffeine than without, suggesting that caffeine administration may delay ROP progression. Furthermore, this effect was more pronounced in the stratified subgroup of infants with gestational age less than 28 weeks.”  

However, caffeine therapy alone was inadequate in preventing severe ROP in the most vulnerable cases, as all four infants with a gestational age of less than 23 weeks progressed to severe ROP, despite caffeine therapy 

The study authors said despite some limitations to the study, it demonstrated that caffeine therapy may be a potential treatment for preventing the progression of severe ROP in neonates with gestational age of less than 32 weeks and birth weight less than 1.5 kg, especially in those with gestational age between 23 and 28 weeks. 

Evaluation of optimal dosage and duration of caffeine administration is warranted in future studies, they said.  

Reference 

1. Otsuka Y, Taketani F, Hirose M, Oh H. caffeine therapy reduces severe retinopathy of prematurity in neonates with gestational age between 23 and 28 weeks. Ophthalmol Sci. 2025 Aug 6;6(1):100903. doi: 10.1016/j.xops.2025.100903. Erratum in: Ophthalmol Sci. 2026 Jan 15;6(2):101002. doi: 10.1016/j.xops.2025.101002.