Retinopathy of Prematurity

Retinopathy of prematurity (ROP) is an eye disorder that primarily affects the eyes of premature babies. The condition usually develops in both eyes and is one of the most common causes of vision loss in childhood.

The smaller the baby, the more likely it is to develop ROP. The retina (light receptive layer of tissue at the back of the eye) develops very slowly in the fetus and the complete growth of blood vessels is seen only at the end of pregnancy period. The retina requires a constant supply of oxygen in order to function properly. If the baby is born preterm, incomplete growth of blood vessels can cause the retina to not receive enough oxygen, triggering the abnormal development of new blood vessels. These abnormal blood vessels are fragile and can bleed. Later they may pull the retina out of position causing a retinal detachment. Retinal detachment leads to severe loss of vision. If not treated at the correct time, ROP can cause permanent loss of vision.

The most important risk factors for ROP are premature birth (before 32 weeks gestation) and low birth weight (less than 1500-1800g). The other probable contributing factors include anemia, breathing problems, poor weight gain, and need for blood transfusion. Infants do not develop any external symptoms unless the disease has progressed to retinal detachment.

To diagnose ROP in premature and low birth weight babies, eye drops are instilled into the infants’ eyes to dilate the pupil for viewing the retina. The infants’ eyes are screened weekly or every two weeks until 36 weeks to check for abnormal developments in the retina. In cases where the baby shows signs of ROP, the screenings frequency may vary.

ROP is classified into different stages based on the severity of the disease.  Treatment depends on the severity of retinopathy. Most infants have mild ROP and will not require any treatment.  However severe forms of retinopathy require treatment as babies with ROP are at high risk for developing certain eye disorders such as abnormal eye movements, nearsightedness, glaucoma, crossed eyes and other eye problems.

Treatment options include:

  • Laser photocoagulation surgery:  Considered as the standard of care, a laser is used to prevent new blood vessels from developing.
  • Intravitreal injection of anti VEGF to regress the development of abnormal blood vessels.
  • Vitrectomy surgery:  Used for retinal detachment, this procedure removes the vitreous eye gel and substitutes it with a clear solution to reattachthe detached retina.

For more details on Retinopathy of Prematurity and treatment options, please contact NMC Eyecare.