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Retinopathy of prematurity (ROP) is abnormal blood vessel development in the retina of the eye in a premature infant.
Alternative NamesRetrolental fibroplasia; ROP
Causes, incidence, and risk factorsThe blood vessels of the retina begin to develop 3 months after conception and complete their development at the time of normal birth. If an infant is born very prematurely, eye development can be disrupted. The vessels may stop growing or grow abnormally from the retina into the normally clear gel that fills the back of the eye. The vessels are fragile and can leak, causing bleeding in the eye.
Scar tissue may develop and pull the retina loose from the inner surface of the eye. In severe cases, this can result in vision loss.
In the past, routine use of excess oxygen to treat premature babies stimulated abnormal vessel growth. Currently, oxygen can be easily and accurately monitored, so this problem is rare.
Today, the risk of developing ROP depends on the degree of prematurity. Generally, the smallest and sickest premature babies have the highest risk.
Typically all babies younger than 30 weeks gestation or weighing fewer than 3 pounds at birth are screened for the condition. Certain high-risk babies who weigh 3 - 4.5 pounds or who are born after 30 weeks should also be screened.
In addition to prematurity, other risks factors may include:
- Brief stop in breathing (apnea)
- Heart disease
- High carbon dioxide (CO2) in the blood
- Infection
- Low blood acidity (pH)
- Low blood oxygen
- Respiratory distress
- Slow heart rate (bradycardia)
- Transfusions
The rate of ROP in moderately premature infants has decreased dramatically with better care in the neonatal intensive care unit. Ironically, however, this has led to high rates of survival of very premature infants who would have had little chance of survival in the past.
Since these very premature infants are at the highest risk of developing ROP, the condition may actually be becoming more common again.
SymptomsThere are 5 stages of ROP.
- Stage I: There is mildly abnormal blood vessel growth.
- Stage II: Blood vessel growth is moderately abnormal.
- Stage III: Blood vessel growth is severely abnormal.
- Stage IV: Blood vessel growth is severely abnormal and there is a partially detached retina.
- Stage V: There is a total retinal detachment.
The blood vessel changes cannot be seen with the naked eye. An eye exam is needed to reveal such problems.
An infant with ROP may be classified as having "plus disease" if the dilation and twisting of the blood vessels matches or exceeds a standard photograph.
Symptoms of severe ROP include:
- Abnormal eye movements
- Crossed eyes
- Severe nearsightedness
- White-looking pupils (leukocoria)
High-risk infants and those younger than 30 weeks gestation or born weighing fewer than 3 lbs should have retinal exams.
The first exam usually should be 4 - 9 weeks after birth, depending on the baby's gestational age. Babies born at 27 weeks or later usually have their exam at 4 weeks of age. Those born earlier usually have exams later.
Follow-up examinations are determined based on the results of the first exam. Babies do not need another examination if the blood vessels in both retinas have completed normal development.
Parents should know what follow-up eye exams are needed before the baby leaves the nursery.
TreatmentEarly treatment has been shown to improve a baby's chances for normal vision. Treatment should start within 72 hours of the eye exam.
Some babies with "plus disease" need immediate treatment.
Treatment may include cryotherapy (freezing) to prevent the spread of abnormal blood vessels.
Laser therapy (photocoagulation) may be used to prevent complications of advanced ROP. The laser therapy stops the abnormal blood vessels from growing. It can be performed in the nursery using portable equipment. To be effective, it must be done before scarring and detachment occurs
Surgery is needed if the retina detaches. Surgical procedures continue to improve, but may not result in good vision.
Expectations (prognosis)Most premature infants with ROP recover with no lasting visual problems. Many premature infants with slight problems in retinal blood vessel growth have the vessels return to normal without treatment. Most infants with mild ROP can be expected to recover completely.
About 1 out of 10 infants with early changes will develop more severe retinal disease. Severe ROP may lead to significant vision problems or blindness. The most important factor in the outcome is early detection and treatment.
ComplicationsComplications may include severe nearsightedness and blindness.
Most infants with severe vision loss related to ROP have other complications of prematurity and require a multidisciplinary approach to rehabilitation.
PreventionThe most effective prevention of retinopathy of prematurity is prevention of premature birth. Preventing other complications of prematurity (such as neonatal respiratory distress syndrome) may also help prevent ROP.
ReferencesSection on Ophthalmology American Academy of Pediatrics, American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus. Screening examination of premature infants for retinopathy of prematurity. Pediatrics. 2006 Feb;117(2):572-6.
Early Treatment For Retinopathy Of Prematurity Cooperative Group. Revised indications for the treatment of retinopathy of prematurity: results of the early treatment for retinopathy of prematurity randomized trial. Arch Ophthalmol. 2003 Dec;121(12):1684-94.
International Committee for the Classification of Retinopathy of Prematurity. The International Classification of Retinopathy of Prematurity revisited. Arch Ophthalmol. 2005 Jul;123(7):991-9.
Tasman W. Retinopathy of Prematurity: the life of a lifetime disease. Am J Ophthalmol. Jan 2006; 141(1): 167-74.
Yanoff M, Duker JS, Augsburger JJ, et al. Ophthalmology. 2nd ed. St. Louis, Mo: Mosby; 2004.
What else can I help you with?
What is the medical condition retinopathy of prematurity in premature infants?
Retinopathy of prematurity is a condition in which the blood vessels in the baby's eyes do not develop normally, and can, in some cases, result in blindness.
What is the differential diagnosis of retinopathy of prematurity?
night blindness and congenital syphillis
What does the term ROP stand for?
1) Regional Occupational Program 2) Retinopathy of Prematurity
What is riprop?
RIPROP is a group that raises money for research into preventative measures and treatment for premature babies affected by Retinopathy of Prematurity (ROP).
What are some of the common medical conditions that occur in premature infants?
The medical conditions that may occur are respiratory distress syndrome, necrotizing enerocolitis, intraventricular hemorrhage, apnea of prematurity, patent ductus arteriosus, retinopathy of prematurity.
What does ROP stand for?
ROP stands for Retinopathy of prematurity which is an eye disease that affects premature babies. ROP also is the stock market abbreviation used for Roper Industries, Inc.
Nursing interventions in having Retinopathy of prematurity?
Nursing interventions for infants with Retinopathy of Prematurity (ROP) include careful monitoring of the infant's oxygen levels to prevent fluctuations that can exacerbate the condition. Nurses should perform regular eye assessments and ensure follow-up appointments with an ophthalmologist are scheduled. Educating parents about ROP and its implications is also crucial, as is promoting a supportive environment that minimizes stress for the infant. Additionally, maintaining a stable temperature and minimizing bright light exposure can help protect the developing retina.
In diabetic retinopathy is the retinopathy the ethology and the diabetes the manifestation?
In diabetic retinopathy, the retinopathy is the manifestation.
Can retinopathy be cured?
Nonproliferative retinopathy has a better prognosis than proliferative retinopathy. Prognosis depends upon the extent of the retinopathy, the cause, and promptness of treatment.
What is retinopathy?
What is Retinopathy of prematurity (ROP)This information was developed by the National Eye Institute to help patients and their families search for general information about retinopathy of prematurity (ROP). An eye care professional who has examined the patient's eyes and is familiar with his or her medical history is the best person to answer specific questions. What is retinopathy of prematurity?Retinopathy of prematurity (ROP) is a potentially blinding eye disorder that primarily affects premature infants weighing about 2¾ pounds (1250 grams) or less that are born before 31 weeks of gestation (A full-term pregnancy has a gestation of 38 42 weeks). The smaller a baby is at birth, the more likely that baby is to develop ROP. This disorder which usually develops in both eyes is one of the most common causes of visual loss in childhood and can lead to lifelong vision impairment and blindness. ROP was first diagnosed in 1942.Frequently Asked Questions about Retinopathy of PrematurityHow many infants have retinopathy of prematurity?Today, with advances in neonatal care, smaller and more premature infants are being saved. These infants are at a much higher risk for ROP. Not all babies who are premature develop ROP. There are approximately 3.9 million infants born in the U.S. each year; of those, about 28,000 weigh 2¾ pounds or less. About 14,000 16,000 of these infants are affected by some degree of ROP. The disease improves and leaves no permanent damage in milder cases of ROP. About 90 percent of all infants with ROP are in the milder category and do not need treatment. However, infants with more severe disease can develop impaired vision or even blindness. About 1,100 1,500 infants annually develop ROP that is severe enough to require medical treatment. About 400 600 infants each year in the US become legally blind from ROP.
Will eyesight return after retinopathy?
Retinopathy from diabetes eyesight recoverd
What is the accented syllable for retinopathy?
Retinopathy is accented on the third syllable.
