Retinopathy of Prematurity

What Is Retinopathy of Prematurity?

Retinopathy of prematurity (ROP) refers to the presence of abnormal blood vessels and scar tissue growing within and over the retina. This condition, formerly called retrolental fibroplasia, primarily it affects premature babies weighing less than three pounds at birth. Retinopathy of prematurity can be detected in the neonatal care unit or nursery by an ophthalmologist (eye physician and surgeon) during an ophthalmoscopic examination of the infant’s dilated eye. 

What Causes ROP? 
The causes are complex and not 
completely understood. An old school of thought says that oxygen was entirely responsible for all cases of ROP. Newer evidence indicates this is not true. Factors which appear to influence this condition are primarily the degree of prematurity and birth weight. For example, the chance of a baby developing ROP who weighs three pounds at birth is about 5%, but increases to 40% or more for an infant weighing less than two pounds. The retinal blood vessels in a very small, premature baby seem to develop abnormally during the therapy necessary for the infant’s survival. 

Will ROP Affect Vision? 
When the diagnosis of ROP is first made, it is difficult to predict how muchthe eyesight will be affected. In many infants, the abnormal blood vessels shrink or go away without affecting vision. In others with more extensive disease, bleeding and scar tissue may lead to distortion or detachment of the retina. This may result in moderate to severe loss of vision. Only a very small percentage of babies become blind. Nearsightedness (myopia) is common in children with ROP. Glasses may improve the vision of these children, unless the eye is badly damaged. 

Can ROP Be Prevented? 
The sophisticated medical care provided in modern neonatal intensive care units has improved the survival chances of very small babies and consequently ROP has become more common in this group. Unfortunately, laboratory and clinical research has not yet found a way to prevent ROP in all babies. 

Can ROP Be Treated? 
Some babies’ eyes with ROP do well without any treatment. In more severe cases, cryotherapy (freezing) shows promise as a treatment. The pen-like tip of the cryotherapy instrument briefly freezes peripheral areas of the retina through the outer wall of the eye. When successful, the treatment can slow down or reverse the abnormal growth of blood vessels and scar tissue. Nevertheless, there is still a definite risk of serious vision loss even with this treatment. The long-term effects of cryotherapy for ROP are not known.

The other and safer modality of treatment is Laser, in this we laser the retina and thus not only prevent the chances of retinal detachment but also decrease the oxygen demand of the retina