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Retinopathy Of Prematurity (ROP) - Dr. Nahla Al Shafie

October 27 2015

Retinopathy Of Prematurity (ROP) is an eye disorder affecting premature infants. This disorder, called “Retrolental Fibroplasia” in the past, occurs in premature babies when abnormal blood vessels and scar tissue grow over the retina and can progress to tractional retinal detachment and total blindness. Therefore, it is considered one of the major cause of blindness throughout the world.

In addition to low birth weight and how premature a baby is born, other risk factors contributing to the development of ROP are: anemia, blood transfusions, respiratory distress, breathing difficulties and the overall health of the infant.

Premature infants with ROP do not usually have symptoms. External signs develop only after the disease has become severe or progressed to retinal detachment, so timely detection of ROP depends on examination by an ophthalmologist experienced in the examination of premature infants.

Approximately, 10% of the babies screened for ROP will require treatment; laser photocoagulation has long surpassed cryotherapy as the standard of care. Laser spots are placed in the areas of retina that failed to develop normal blood vessels, in an attempt to slow down or reverse the growth of abnormal blood vessels and scar tissue formation.

Recent research studies have also shown that “Bevacizumab”, which is a medication that blocks vascular endothelial growth factor responsible for the appearance of the abnormal blood vessels when injected directly into the eye, can be used as an alternative treatment in a small number of premature infants with ROP.

 

As a conclusion, premature infants should be examined using binocular indirect ophthalmoscopy if they are born at a gestational age of 32 weeks or less or if their birth weight is less than 1,500gm or gestational age of more than 32 weeks but with an unstable clinical course identified by the neonatologist to be at high risk for developing ROP.