What is Retinopathy of Prematurity?

Retinopathy of prematurity (ROP), also named retrolental fibroplasia (RLF) and Terry syndrome, is a disorder of the eye affecting prematurely born babies. When a baby is born prematurely, the retinal blood vessels can grow abnormally. Mainly, having received neonatal intensive care, in which oxygen therapy is utilized due to the premature development of their lungs. Most ROP is cured without causing harm to the retina. When ROP is severe, it can cause the retina to pull away or detach from the wall of the eye and possibly result in blindness.

Causes:
Gestational age and birth weight, Oxygen saturation levels- During the acute first phase, the normal vasculogenesis of the retina is disturbed by the relative hyperoxia of the extrauterine environment. This causes vaso-obliteration and non-vascularisation of some areas of the anterior retina. The subsequent hypoxia causes a second chronic phase, characterized by the proliferation of vascular and glial cells, arteriovenous shunt formation, occasionally leading to involution or permanent cicatricial changes and visual impairment. Genetic factors may also contribute to the development of ROP

Signs and symptoms:
Only an ophthalmologist (a doctor who specializes in caring for eyes) who is trained to identify and treat ROP can spot these signs, using special instruments to analyze your child’s retina. Because many of the signs of retinopathy of prematurity happen deep inside the eye, which means you won’t be able to see them just by looking at your child. An infant with severe ROP might develop visible difficulties, such as nystagmus (abnormal eye movements) and leukocoria (white pupils).

Diagnosis:

Ophthalmologists (Eye MDs) who are skilled in the examination of an infant's eyes make the diagnosis of ROP.

Examinations are performed to analyze the eyes after the pupils are dilated with drops.

Infants less than 1500 grams (3.3 lbs) and with a gestational age less than 31 weeks undergo eye examinations to monitor for ROP

Other infants who are deemed high risk by the neonatologist might also be screened.

Treatment:
Peripheral retinal ablation is the cornerstone of ROP treatment. The destruction of the avascular retina is executed with a solid-state laser photocoagulation device.
Injection of medication- Avastin or Lucentis have both been used) into the eye that stops a signal that is causing the abnormal blood vessels to form. These medications may be used as an alternative to, or in addition to, laser treatment.
Scleral buckling and/or vitrectomy surgery may be considered for severe ROP (stages 4 and 5) for eyes that progress to retinal detachment.

Prevention:
Since the certain reason for retinopathy of prematurity isn’t known, the best prevention is prenatal care to curtail the likelihood of premature birth. Although, doctors can only help in curbing its most destructive effects through careful screening and treatment.