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Retinopathy of prematurity

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Retinopathy of prematurity (ROP) is a developmental vascular proliferative disorder that occurs in the retina of preterm infants with incomplete retinal vascularization. It is a potentially blinding disease caused by abnormal development of retinal blood vessels in premature infants.  When a baby is born prematurely, the retinal blood vessels can grow abnormally. Most ROP resolves without causing damage to the retina. When ROP is severe, it can cause the retina to pull away or detach from the wall of the eye and possibly cause blindness. Babies 1250 grams or less and are born before 31 weeks gestation are at highest risk.

Most often, retinopathy occurs simultaneously in both eyes.

 

Risk factors

Birth weight and gestational age are the most important risk factors for development of severe ROP. Other factors that are associated with the presence of ROP include anemia, poor weight gain, blood transfusion, respiratory distress, breathing difficulties and the overall health of the infant. Close monitoring has decreased the impact of oxygen use as a risk factor for development of ROP. Light levels do not affect severity of ROP.

Diagnosis of retinopathy of prematurity

Infants less than 1500 grams and with a gestational age less than 31 weeks undergo eye examinations to monitor for ROP. Examination of a premature baby will take place 3-4 weeks after birth.

Subsequently, it is absolutely necessary to be followed-up weekly by an ophthalmologist. For children suspected of retinopathy, ophthalmologists examine the eyes after the pupils are dilated with drops.

Keep in mind that in order to maintain your children’s visual health, diagnostic examination of vision should be as important and regular as vaccinations and visits to pediatrician. Development, integration into society and the future of the child depend on his vision.

The treatment of retinopathy of prematurity

According to medical statistics, there are many cases where improvement in the condition of children with retinopathy of grade I-II has occurred without specific treatment.

Laser photocoagulation is the preferred treatment of choice. Laser ablation is applied to the immature portion of the retina.  If laser is not available, cryotherapy may be performed.

It is important to diagnose aggressive posterior ROP and treat it immediately, as this form of ROP can rapidly progress to retinal detachment.

If laser or cryotherapy fails to prevent progression of ROP and the patient develops a retinal detachment, surgery (vitrectomy, scleral buckle) may be performed.

Eyes with retinal detachment caused by ROP generally have a poor visual prognosis.

 

Follow-Up

Patients with a history of ROP have a higher incidence of astigmatism, high myopia, and retinal detachment and should be followed routinely.

 

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