Retinopathy of Prematurity
- Fibrovascular proliferation in retina of pre-term infants
- Cause is premature exposure to extra-uterine environment rich in oxygen
- Occurs in 80% of neonates weighing less than 1000gm and in 20% weighing between 1000gm and 1250gm
- Pathology develops first in peripheral retina at 30 to 45 weeks of postmenstrual age and often regresses spontaneously, but...
- Retinal detachment is feared complication
- Earliest sign is zone of avascularity in far peripheral retina that can be detected only with skilled indirect ophthalmoscopy
- In advanced disease, fibrovascular proliferation may extend to optic disc and drag it ("dragged disc")
- Nothing, but...
- Challenge is to recognize subtle early signs so that...
- Baby can be examined frequently to detect dangerous progression
- Arrange for at-risk babies to be examined at about 4 weeks after birth by ophthalmologist skilled in screening for this condition
- Screening examinations will continue until retinal vessels have grown out to retinal periphery such that retinopathy will not occur
- Most retinopathy of prematurity regresses spontaneously, but when signs of dangerous progression are found...
- Treatment consists of laser photocoagulation, shown to be effective in reducing vision loss