Retinopathy of prematurity

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Retinopathy of prematurity
Synonyms	ROP
Pronounce
Specialty	Ophthalmology
Symptoms	Abnormal blood vessel development in the retina
Complications	N/A
Onset	Premature infants
Duration
Types
Causes	Premature birth
Risks	Low birth weight, early gestational age
Diagnosis	Eye examination
Differential diagnosis
Prevention
Treatment	Laser therapy, cryotherapy, anti-VEGF therapy
Medication
Prognosis	Varies; can lead to blindness if untreated
Frequency
Deaths

A disease of the eye affecting premature infants

Premature birth is a significant risk factor for the development of ROP.

The retina (red) is detached at the top of the eye.

The silicone band (scleral buckle, blue) is placed around the eye. This brings the wall of the eye into contact with the detached retina, allowing the retina to re-attach.

A retinal image showing the effects of Retinopathy of Prematurity (ROP).

Retinopathy of prematurity (ROP) is a potentially blinding eye disorder that primarily affects premature infants. It is characterized by abnormal development of retinal blood vessels. The condition can lead to retinal detachment and blindness if not properly managed.

Pathophysiology

ROP occurs when the normal development of the retinal blood vessels is disrupted. In a full-term infant, the blood vessels of the retina finish developing in the last few weeks of pregnancy. However, in premature infants, this process is incomplete. The abnormal growth of these vessels can lead to scarring and pulling on the retina, potentially causing retinal detachment.

Risk Factors

Several factors increase the risk of developing ROP, including:

• Premature birth, particularly before 31 weeks of gestation
• Low birth weight, especially less than 1500 grams
• High levels of oxygen therapy
• Sepsis
• Respiratory distress syndrome

Stages

ROP is classified into five stages, ranging from mild (Stage 1) to severe (Stage 5):

• Stage 1: Mildly abnormal blood vessel growth.
• Stage 2: Moderately abnormal blood vessel growth.
• Stage 3: Severely abnormal blood vessel growth.
• Stage 4: Partial retinal detachment.
• Stage 5: Total retinal detachment.

Diagnosis

ROP is diagnosed through a comprehensive eye examination by an ophthalmologist. The examination involves dilating the infant's pupils and using an ophthalmoscope to view the retina. Regular screenings are recommended for at-risk infants.

Treatment

Treatment for ROP depends on the severity of the condition. Options include:

• Laser therapy: Used to stop the abnormal growth of blood vessels.
• Cryotherapy: Freezing treatment to prevent further retinal damage.
• Anti-VEGF injections: Medications injected into the eye to inhibit the growth of abnormal blood vessels.
• Surgery: In advanced cases, surgery may be necessary to reattach the retina.

Prognosis

The prognosis for infants with ROP varies. Many infants with mild ROP improve without treatment and have normal vision. However, severe ROP can lead to significant visual impairment or blindness. Early detection and treatment are crucial for improving outcomes.

Prevention

Preventive measures focus on minimizing risk factors, such as careful monitoring of oxygen levels in premature infants and ensuring proper prenatal care to reduce the risk of premature birth.

See also

• Premature birth
• Blindness
• Retinal detachment
• Ophthalmology

Classification	ICD-10: H35.1 ICD-9-CM: 362.20, 362.21 OMIM: 133780 MeSH: D012178 DiseasesDB: 11442
External resources	MedlinePlus: 001618 eMedicine: oph/413 ped/1998 Orphanet: 90050

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