Retinopathy of Prematurity (ROP)

Retinopathy of prematurity is an eye disease caused by the abnormal growth of the blood vessels in the retina; it has the potential to lead to blindness. 

  • Premature birth is the single largest cause of retinopathy in infants, with the greatest incidence found in those who are born around 26 weeks of pregnancy or earlier.
  • In some cases of retinopathy, the rapid, disorganized growth of the small blood vessels in the retina may result in their bleeding, often causing extensive scarring of the infant’s retina, which may lead to blindness.
  • Retinopathy of prematurity is asymptomatic, and is detected when the newborn’s eyes are examined by an ophthalmologist.
  • Retinopathy of prematurity often resolves on its own, without any treatment, especially in mild cases. However, frequent eye examinations are required to monitor the progress of the blood vessel development till they are completely developed.
  • Laser treatment is used to treat severe cases of retinopathy to prevent blindness.

The development of blood vessels in the retinal wall may be arrested for an initial period, in infants born extremely premature. Later on, the blood vessel growth starts again, but they may grow in a rapid, irregular, and disorganized way. It may cause bleeding of these small vessels, often resulting in scarring. The retina may get detached from the eye wall at the back, leading to blindness. Oxygen toxicity, which results from the active treatment of respiratory distress in premature infants, is found to be a reason for the development of retinopathy.

Retinopathy of prematurity is asymptomatic in infants who develop this condition. Unless an ophthalmologist examines the back of the premature infant’s eyes, it may remain undiagnosed till it progresses to loss of vision.

Prevention and Treatment

Premature infants with a birth weight of 3 pounds or less (1,500 grams or less) should be examined by an ophthalmologist to detect abnormalities in the growth of the retinal blood vessels. Weekly eye examinations are necessary till the blood vessel growth is completed. Yearly eye examinations are recommended for those who have severe retinopathy as infants. When abnormal blood vessel growth is detected, it can be treated to prevent the detachment of the retina and vision loss.

When supplemental oxygen is given to premature infants to reduce respiratory distress, care should be taken to keep the oxygen concentration to the minimum required. Blood oxygen levels should be checked frequently to ensure the lowest necessary level. A pulse oximeter connected to a finger or a toe can continuously measure oxygen levels in the blood.

Retinopathy of prematurity often disappears on its own, especially in mild cases. Laser treatment is an option if retinopathy is very severe. The outer layers of the retina is treated with lasers, which often prevents abnormal blood vessel growth and reduces the possibility of the retina becoming detached and causing blindness.

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Yasser Elnahas

MD, PHD, Professor Of CardioVascular Surgery
Dr. Yasser Elnahas, Is an associate Professor of Cardiovascular Surgery. Dr. Elnahas was trained as a fellow At Texas Heart Institute And Mayo Clinic Foundation.Dr. Elnahas is dedicated to educating the general public about different disease conditions and simplifying the medical knowledge in an easy to understand terminology.

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