Retinopathy of Prematurity
What is retinopathy of prematurity?
Retinopathy of prematurity (ROP) is a disorder of the blood vessels of the retina (the light sensitive part of the eye). ROP is a disease of premature babies. Generally, the more premature the baby and the lower the birthweight, the greater the risk for developing ROP. This disorder has in the past been called retrolental fibroplasia. The blood vessels of the retina are not completely developed until the baby reaches full term. When a baby is born prematurely, the blood vessels may not have fully developed. They may have growth of abnormal blood vessels, or damage and scarring of existing blood vessels in the retina. The scarring and bleeding can lead to retinal scarring or detachment from the back of the eye, resulting in vision loss.
Why is retinopathy of prematurity a concern?
There are five stages of ROP, from a mild Stage 1 to severe Stage 5 when the retina detaches, leading to blindness. Most babies with Stage 1 and 2 ROP show improvement without treatment. However, in the absence of treatment, about half of babies with Stage 3 and most with Stage 4 progress to blindness.
Management of retinopathy of prematurity:
In 2001, the American Academy of Pediatrics (AAP) developed guidelines for a screening program to identify babies at risk for ROP. These guidelines include the following:
- at least two eye examinations, by a qualified ophthalmologist, for very low birthweight or premature babies (less than 28 weeks gestational age), as well as other premature or low birthweight babies who have unstable conditions
- eye examination should be done at four to six weeks of age, or when the baby reaches 31 to 33 weeks gestational age
- follow-up eye examinations at appropriate times
- treatment of babies who progress to Stage 3 or greater within 72 hours of diagnosis
Treatment of retinopathy of prematurity:
Early diagnosis of damage is important in the treatment of ROP. Babies who develop severe ROP may benefit from cryopexy (freezing)or laser photocoagulation to stop progression of the disease. Surgical treatment may be indicated if the retina detaches. In some cases the disease progresses to retinal detachment and blindness despite our best efforts.
Prevention of retinopathy of prematurity:
Preventing premature births is the key to preventing ROP. However, research is ongoing to find ways to treat this and other problems of prematurity.
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