What causes Retinopathy of Prematurity?
It is caused by loss of development of blood vessels in peripheral parts of retina along with formation of abnormal, fragile blood vessels which later get scarred and contract pulling the retina and causing Retinal Detachment.
What are the symptoms of ROP?
The baby presents with white pupil (leukocoria), abnormal eye movements ( nystagmus), crossed eyes ( squint) and severe near sightedness.
Do premature babies have eye problems?
ROP is one of the commonest eye problem in premature babies especially who weigh less than 2 lbs 12 oz. It is caused due to formation of abnormal blood vessels on the retina and can lead to a lifelong blindness.
Can too much oxygen make the baby blind?
In premature infants with low birth weight who have been given oxygen , ROP has been found to occur more frequently.
Is ROP progressive?
ROP has been classified into 5 stages depending upon its severity. In many cases of Stage 1 ROP, there is spontaneous regression.
What are stages of ROP?
Stage 1 ROP – in this there are mild abnormal blood vessels. This stage usually resolves on its own without any treatment.
Stage 2 ROP – there are moderately abnormal blood vessels.
This stage also usually doesn’t require any treatment.
Stage 3 ROP – severely abnormal blood vessels are found on the retina.
Some of these vessels may grow towards the centre of the retina. In the centre of retina , some vessels may become dilated and twisted. This is known as PLUS disease.
Stage 3 patients may or may not require the treatment. How ever, in infants with PLUS disease, treatment may be considered as it indicates worsening of disease.
Stage 4 ROP – is partial retinal detachment due to traction of fibrovascular bands caused by bleeding and scarring of abnormal blood vessels.
Urgent surgical intervention is needed to save vision.
Stage 5 ROP – is complete retinal detachment.
Vision cannot be restored without surgery in these cases
How is ROP treated?
One of the most effective therapies for ROP is Laser Or Cryotherapy which selectively destroys the avascular retina. This leads to the regression of abnormal blood vessels on the retina.
If there is retinal detachment then surgical management in the form of vitrectomy or scleral buckle surgery is undertaken.
Does ROP cause blindness?
It can lead to blindness in serious cases.
Can ROP be prevented?
It might be prevented by regulating retinal oxygen tension. High levels of oxygen should be avoided in premature babies.
Why does oxygen cause ROP?
High levels of oxygen given to premature babies at birth cause an increase in the arterial oxygen saturation. Hence when the preterm infant is weaned off the oxygen then the avascular retina becomes hypoxic and it secretes angiogenic factors which cause formation of abnormal blood vessels.
Is ROP hereditary?
No it is not hereditary.
How do you do ROP screening?
Screening should be done early ( 2-3 weeks after birth ) in case the gestational age is 28 weeks and birth weight is 1200 gms by an experienced ophthalmologist who knows to use indirect ophthalmoscope properly.
Can ROP be reversed?
Laser treatment or cryotherapy selectively destroy the hypoxic retina and cause regression of abnormal blood vessels, however there is some loss of peripheral vision too.