Retinopathy of Prematurity (ROP) is a retinal disorder seen in low-birth-weight premature infants. It may be mild with no visual defects, or it may become aggressive with abnormal new blood vessel formation and progress to retinal detachment and blindness.
Nearly one-third to half of neonates undergoing screening may show some degree of ROP which fortunately regresses on its own in the majority of affected infants. However, in a few infants it progresses to retinal detachment and blindness. Timely screening and treatment of ROP can prevent blindness and minimise visual handicaps.
Birth weight and gestational age are the most important risk factors for development of severe ROP. Infants with very low birth weight are at significantly higher risk of developing severe ROP that requires treatment.
Similarly, the severity of ROP is inversely proportional to gestational age. This means the earlier the baby is born, the higher the risk of developing ROP. Present evidence shows that low birth weight and gestational age are the most predictive risk factors for the development of ROP.
In general, other risk factors are surrogate markers of sickness in the baby. Therefore, the sicker the baby, the higher is the risk.
Screening should be carried out for infants with either of the following conditions:
Infants with an unstable clinical course who are considered high risk by a neonatologist or paediatrician should also be screened.
To simplify, most babies should undergo screening at 4 weeks after birth, but very premature or extremely low birth weight babies require earlier screening.
Follow-up examinations are recommended by the examining ophthalmologist depending on the retinal findings.
In general, screening examinations continue every two weeks until:
The main aim of treatment is to reduce the incidence of retinal detachment and blindness by early detection and appropriate treatment of ROP.
