Retinopathy of Prematurity – Stages, Cause, Treatment

Retinopathy of Prematurity - Stages Cause Treatment

You might have heard this word but you still wonder what it is right.  

Retinopathy of Prematurity (ROP) is a condition when there is an abnormal development of the retina vessels in premature infants. We all know that the retina is the inner layer of the eye that receives light and then turns Iight into visual images which are then sent to the brain.  In most cases the ROP gets cured without causing any damage to the retina. But when it becomes severe, it can pull the retina away from the wall of the eye and lead to blindness.  

How will Retinopathy of Prematurity affect your baby?  

Like I said most babies even when they have ROP see normally. Their vision is at risk when ROP progresses to a severe stage. But the unfortunate part is none of us can predict which baby will be fine and which one will progress to a severe form of the disease. Hence it is crucial that you take your baby for regular check up as effective screening and a timely management can prevent the baby from having a vision loss.  

What are the risk factors? 

The baby’s birth weight and the gestational age are the 2 most important risk factors for the development of ROP. Babies less than 1250 grams or those born before 31 weeks of gestation are at the highest risk. Other factors that can lead to ROP include anemia, poor weight gain, blood transfusion, respiratory distress of the infant.  

Stages of Retinopathy of Prematurity? 

A skilled ophthalmologist wil be able to evaluate the infant’s eye and make the diagnosis of ROP. The pupils are dilated with a dilating drop and then examined. ROP is described by its location (zone), the severity of the disease (stage) and the appearance of the retinal vessels (plus disease).  

Stage 1- demarcation line that separates normal from premature retina 

Stage 2- ridge which has a height and width 

Stage 3- growth of fragile new abnormal vessels 

Stage 4- partial retinal detachment 

Stage 5- complete retinal detachment 

When to start treatment for Retinopathy of Prematurity? 

When the ROP progresses and potentially leads to retinal detachment and even loss of vision then immediate action has to be taken.  

There options are: 

Laser -this is the most common method where laser shots are ablated at the immature retina. 

Injection – this is a newer modality of treatment. Injection Anti VGEF is injected into the eye that stops sending signals that are responsible for the formation of abnormal blood vessels. This can be an alternative or in addition to laser. 

The above two modalities of treatment have shown to be successful. But at times despite accurate diagnosis and timely laser treatment, the ROP can continue to progress and gradually pull the retina away from the eye ball. 

 In conditions where retinal detachment has occurred, it can be treated with vitrectomy or sclera bucking procedure. However eyes with retinal detachment caused by ROP generally have a very poor visual prognosis.  

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