Northeast Wisconsin Retina Associates

CLINICAL CONDITIONS

RETINOPATHY OF PREMATURITY (ROP)

Retinopathy of prematurity (ROP) is a disorder of retinal development which occurs in prematurely born infants. During gestation the retina begins to grow from the optic nerve and slowly progresses forward toward the front of the eye. Ordinarily this development process is complete at approximately 40 weeks. If a child is born prematurely, the growth of the retina is not yet complete. The more prematurely an infant is born, the less time there has been for normal development. In some premature infants retinal development continues normally after birth. In many children however, this process stops and a series of abnormalities begin to develop which are called retinopathy of prematurity (ROP).

In most cases, ROP develops to a mild extent, stabilizes and then disappears (regresses). Completion of normal retinal development then follows. In a small number of cases, ROP continues to progress and may reach a point where there is a significant threat for development of scar tissue proliferation, retinal detach­ment and severe loss of vision. In these infants laser treatment becomes necessary in the hope of halting progression of the disease process and preserving vision.

The lower the birth weight of an infant and the more prematurely he/she is born, the greater is the risk for development of ROP problems. Since it is impossible to predict which babies will face serious problems, all premature infants weighing less than 1250 grams (about three pounds) require periodic surveillance retinal examinations while hospitalized in the Neonatal Intensive Care Unit (NICU) and occasionally following discharge home.

Although modern treatment has reduced the potentially devastating effects of retinopathy of prematurity, there are significant limitations which should be recognized in the management of this disease. Vision is an extremely complex neurologic process. The initial reception and generation of visual information occurs in the retina, however extensive processing occurs throughout the visual pathways in the brain which may also be affected by other abnormalities related to premature birth. Additionally, with or without abnormalities due to ROP, premature infants may experience a variety of other eye problems during early childhood including amblyopia (lazy eye), strabismus (misalignment of the eyes) or need for glasses. Any of these difficulties may interfere with development of normal vision. Even after ROP-related problems have resolved therefore, premature infants often require ongoing attention by a pediatric or general ophthalmologist.

An excellent website with additional information regarding ROP and related pediatric retinal disorders is www.ROPARD.org.

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