Retinopathy of Prematurity (ROP)

What Causes Retinopathy of Prematurity?

The exact cause of ROP is unknown, but premature birth and low birth weight are the most significant risk factors. The blood vessels in the eyes of premature infants are not fully developed and continue to grow after birth.

Abnormal vessel development can be influenced by factors such as oxygen deficiency, infection, and light. Risk factors for ROP include:

⬩Infants born before 32 weeks of gestation or weighing less than 1500 grams are at the highest risk for ROP.

⬩Birth weight less than 2000 grams increases the risk of ROP.

⬩Infants who receive respiratory support after birth have a higher risk of ROP.

⬩Infants with congenital heart disease have a higher risk of ROP.

⬩Infants with blood infections have a higher risk of ROP.

⬩Infants with brain hemorrhage have a higher risk of ROP.

How is Retinopathy of Prematurity Examined?

ROP examination is a procedure performed by an ophthalmologist to determine the presence and severity of ROP. Eye drops are used to dilate the infant's pupils before the examination. Anesthetic drops may also be used to ensure the infant's comfort.

During the examination, the doctor uses a special instrument called an indirect ophthalmoscope to examine the infant's retina. The doctor holds the ophthalmoscope at different angles to view various parts of the retina. The examination is painless and takes only a few minutes.

When and How Often Should Premature Infants Be Examined for Retinopathy of Prematurity?

Early diagnosis and treatment are crucial to stopping the progression of ROP and preventing blindness. Therefore, all infants in the risk group should undergo regular eye examinations after birth.

The first examination is usually performed between 4-6 weeks after birth. For very premature infants (born before 30 weeks or weighing less than 1250 grams), the first examination can be delayed up to 8 weeks. Examinations for infants in intensive care can be conducted with portable devices in the intensive care setting.

After the initial examination, the frequency of examinations depends on the stage of ROP and the infant's risk factors:

⬩Infants at high risk for ROP may need examinations every 1-2 weeks.

⬩Infants at low risk for ROP may need examinations every 3-4 weeks.

⬩Infants are monitored until the retinal blood vessels are fully developed, around 45-50 weeks.

If your baby is premature, it is important to discuss ROP screenings with your doctor. Based on your baby's risk factors, your doctor will recommend a specific screening schedule. ROP screenings are an important preventive measure to help protect your baby's vision.

What is the Treatment for Retinopathy of Prematurity?

Retinopathy of Prematurity (ROP) is a serious eye condition that develops in premature and low birth weight infants. The abnormal growth and proliferation of blood vessels can damage the retina (the light-sensitive layer of the eye), leading to vision loss.

ROP treatment aims to prevent this damage and preserve vision. Treatment varies depending on the stage and severity of the disease. Main treatment options include:

⬩In mild cases of ROP, the disease may regress on its own. The infant undergoes regular eye examinations to monitor the disease's progression.

⬩Laser photocoagulation uses laser light to destroy abnormal blood vessels on the retina.

⬩Anti-VEGF injections deliver medication into the eye to prevent the growth of abnormal blood vessels.

⬩Vitrectomy is a surgical procedure that removes the vitreous gel from the eye to eliminate abnormal blood vessels.

The doctor will create the most appropriate treatment plan for the individual infant. The treatment process varies depending on the stage and severity of the disease. Some infants may need only one treatment, while others may require multiple treatments.