Retinopathy of prematurity (ROP) is abnormal blood vessel development in the retina of the eye. It occurs in infants that are born too early (premature).
Retrolental fibroplasia; ROP
The blood vessels of the retina (in the back of the eye) begin to develop about 3 months into pregnancy. In most cases, they are fully developed at the time of normal birth. The eyes may not develop properly if a baby is born very early. The vessels may stop growing or grow abnormally from the retina into the back of the eye. Because the vessels are fragile, they can leak and cause bleeding in the eye.
Scar tissue may develop and pull the retina loose from the inner surface of the eye (retinal detachment). In severe cases, this can result in vision loss.
In the past, the use of too much oxygen in treating premature babies caused vessels to grow abnormally. Better methods are now available for monitoring oxygen. As a result, the problem has become less common, especially in developed countries. However, there is still uncertainty about the right level of oxygen for premature babies at different ages. Researchers are studying other factors besides oxygen which appear to influence the risk of ROP.
Today, the risk of developing ROP depends on the degree of prematurity. Smaller babies with more medical problems are at higher risk.
Almost all babies who are born before 30 weeks or weigh less than 3 pounds (1500 grams or 1.5 kilograms) at birth are screened for the condition. Some high-risk babies who weigh 3 to 4.5 pounds (1.5 to 2 kilograms) or who are born after 30 weeks should also be screened.
In addition to prematurity, other risk factors may include:
The rate of ROP in most premature infants has gone down greatly in developed countries over the past few decades due to better care in the neonatal intensive care unit (NICU). However, more babies born very early are now able to survive, and these very premature infants are at the highest risk for ROP.
The blood vessel changes cannot be seen with the naked eye. An eye exam by an ophthalmologist is needed to reveal such problems.
There are five stages of ROP:
An infant with ROP may also be classified as having "plus disease" if the abnormal blood vessels match pictures used to diagnose the condition.
Symptoms of severe ROP include:
Early treatment has been shown to improve a baby's chances for normal vision. Treatment should start within 72 hours of the eye exam.
Some babies with "plus disease" need immediate treatment.
Surgery is needed if the retina detaches. Surgery does not always result in good vision.
Sharon Freedman is an Ophthalmologist in Durham, North Carolina. Freedman has been practicing medicine for over 38 years and is rated as an Elite expert by MediFind in the treatment of Retinopathy of Prematurity. She is also highly rated in 17 other conditions, according to our data. Her top areas of expertise are Strabismus, Retinopathy of Prematurity, Brown Syndrome, Glaucoma, and Cataract Removal. She is licensed to treat patients in North Carolina. Freedman is currently accepting new patients.
Cynthia Toth is an Ophthalmologist in Durham, North Carolina. Toth has been practicing medicine for over 40 years and is rated as an Elite expert by MediFind in the treatment of Retinopathy of Prematurity. She is also highly rated in 12 other conditions, according to our data. Her top areas of expertise are Age-Related Macular Degeneration (ARMD), Retinopathy of Prematurity, Late-Onset Retinal Degeneration, Corneal Transplant, and Cataract Removal. She is licensed to treat patients in North Carolina. Toth is currently accepting new patients.
Ann Hellstrom practices in Goeteborg, Sweden. Hellstrom is rated as an Elite expert by MediFind in the treatment of Retinopathy of Prematurity. She is also highly rated in 11 other conditions, according to our data. Her top areas of expertise are Retinopathy of Prematurity, Premature Infant, Infant Hyperglycemia, Intraventricular Hemorrhage of the Newborn, and Hormone Replacement Therapy (HRT).
Most infants with severe vision loss related to ROP have other problems related to early birth. They will need many different treatments.
About 1 out of 10 infants with early changes will develop more severe retinal disease. Severe ROP may lead to major vision problems or blindness. The key factor in the outcome is early detection and treatment.
Complications may include severe nearsightedness or blindness.
The best way to prevent this condition is to take steps to avoid premature birth. Preventing other problems of prematurity may also help prevent ROP.
Summary: The purpose of this study is to determine if an investigational drug can reduce the burden of chronic lung disease in extremely premature infants, as compared to extremely premature infants receiving standard neonatal care alone.
Summary: This is a follow-up study to evaluate the long term outcome of babies treated in the FIREFLEYE study.
Published Date: April 14, 2021
Published By: Charles I. Schwartz, MD, FAAP, Clinical Assistant Professor of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, General Pediatrician at PennCare for Kids, Phoenixville, PA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Fierson WM; American Academy of Pediatrics Section on Ophthalmology; American Academy of Ophthalmology; American Association for Pediatric Ophthalmology and Strabismus; American Association of Certified Orthoptists. Screening examination of premature infants for retinopathy of prematurity. Pediatrics. 2018;142(6):e20183061. Pediatrics. 2019;143(3):2018-3810. PMID: 30824604 pubmed.ncbi.nlm.nih.gov/30824604/.
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Sun Y, Hellström A, Smith LEH. Retinopathy of prematurity. In: Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff and Martin's Neonatal-Perinatal Medicine. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 96.
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