What strategy helps minimize the risk of retinopathy of prematurity in preterm infants?

• A. Keep FiO2 at maximum for extended periods
• B. Maintain oxygen saturations within recommended target ranges and avoid prolonged high FiO2 exposure
• C. Avoid monitoring oxygen saturation
• D. Use room air irrespective of saturation

Answer: (B)

Oxygen management is central to lowering the risk of retinopathy of prematurity. In preterm infants, the developing retina is highly sensitive to oxygen levels. If oxygen exposure is too high for too long (hyperoxia), retinal vessels can constrict or regress, creating conditions that later drive abnormal blood vessel growth when oxygen levels drop. By keeping oxygen saturation within the recommended target range and avoiding prolonged high FiO2, you provide enough oxygen for tissues while minimizing oxidative stress and the sensorimotor fluctuations that promote abnormal retinal neovascularization. This balanced approach—careful titration of FiO2 guided by continuous pulse oximetry to stay within target saturations—helps protect the infant’s retina. Using room air without regard to actual saturation can leave the infant under- or over-oxygenated, and not monitoring oxygen saturation removes the feedback needed to keep levels in a safe range, both of which can increase ROP risk.