Retinopathy Prematurity
Blinding retinal condition known as retinopathy of prematurity (ROP) affects preterm infants and is caused by the growth of aberrant blood vessels in the developing retina.
Retinopathy Prematurity:
What is Retinopathy Prematurity?
Blinding retinal condition known as retinopathy of prematurity (ROP) affects preterm infants and is caused by the growth of aberrant blood vessels in the developing retina. (the light-sensitive layer that is located deep within the cornea of the eye)
When the infant is born full term, the blood vessels that grow along the surface of the developing retina have finished their development. Babies who are born prematurely have inadequate growth, and their blood vessels may develop improperly as a result. These aberrant blood vessels are delicate, and as a result, they are prone to bleeding readily. Scarring can be the result of excessive bleeding. The contraction of this scar tissue causes it to pull on the young retina, which ultimately results in detachment of the retina.
Retinopathy Prematurity Symptoms:
ROP is asymptomatic. Blindness in the infant is often recognized by the parents only at the age of 6-8 months or sometimes even later. So screening is very important for premature babies.
Less severe forms of ROP may be associated with:
Subnormal vision
Crossed eyes and squint
Severe myopia
White reflex in the pupil
Risk factors for ROP
Prematurity
Low birth weight
Prolonged need for oxygen
Infections
Blood transfusions
ROP Stages:
It is categorized into 5 stages: ROP goes through 5 stages of increasing severity. Stage 1 and 2 may sometimes regress. Stage 3 (sight threatening ROP) usually needs treatment. Stage 4 and 5 are the most severe and often have poor visual outcomes despite treatment. Plus disease is a term that indicates a more severe ROP.
Retinopathy of prematurity zones:
The infant retina is divided into 3 zones from inward out with Zone 1 being most critical for vision, zone 2 requiring treatment in stages 3 and beyond, and zone 3 disease usually requiring no treatment.
Retinopathy of prematurity treatment:
Laser photocoagulation is the mainstay of treatment of sight threatening ROP. Stage 3 and Plus disease ROP requires treatment .Stages 4 and 5 require surgery either scleral buckling or vitrectomy. In select cases of Zone 1 disease especially in very sick babies who cannot tolerate laser photocoagulation injection of anti VEGF agents may be given.
Retinopathy of prematurity screening:
Babies born earlier than 34 weeks and weighing less than 2 kg should be screened for ROP by the first 28 days of life. This is usually done by an ophthalmologist trained in the same. Serial examination at weekly or two weekly intervals are done till the growth is complete or to detect if sight threatening ROP is developing