What is retinopathy of prematurity?
Retinopathy of prematurity ("ROP") is a disease of the blood vessels of the retina (the part of the light-sensitive eye). ROP is very common in premature babies. In general, the premature the baby is and the lower its birth weight, the greater the risk of developing ROP. This disease has been known as retrolental fibroblasts.
What causes retinopathy of prematurity?
The exact reason for ROP is not fully known. The retina is the thin layer of nerve fibers and light-sensitive cells that cover the inner and back of the eye. The blood vessels of the retina do not fully develop until the baby reaches term. When a baby is born premature, blood vessels may not have fully developed. They may have abnormal blood vessel growth, damage or scarring of blood vessels already existing in the retina. Scars and bleeding can cause scar tissue or retinal detachment from the back of the eye and loss of vision.
Why is retinopathy of prematurity worrying?
The ROP has five stages, ranging from Stage 1, lighter, to Stage 5, the most severe, in which the retina detaches from the eye. Babies with Stage 1 and 2 ROPs are called pre-threshold, and threshold to those with Stage 3 to 5 ROPs. The rate of improvements without treatment is almost 90% in babies with Stage 1 and 2 ROPs. However, about 50 percent of babies with Stage 3 and most of those with Stage 4 can develop serious eye damage. Each year, between 400 and 600 children are blinded by the ROP.
Retinopathy control of prematurity
In 2012, the American Academy of Pediatrics updated its guidelines for an exam program to identify babies at risk of retinopathy of prematurity. These guidelines include:
- Babies who at birth have a weight less than or equal to 1500 g or a gestational age of 30 weeks or less should undergo retinal exams.
- Babies who at birth weigh between 1500 and 2000 g or have a gestational age greater than 30 weeks and are at high risk should undergo retinal exams.
- Retinal exams of premature babies should be performed by an ophthalmologist with experience in identifying retinal changes in ROP.
- The appropriate time to perform the ROP controls in the acute phase should be determined according to the chronological age of the baby and his gestational age at birth.
- Follow-up exams should be recommended by the ophthalmologist involved as found in the retina.
Treatment of retinopathy of prematurity
Early diagnosis of damage is important for the treatment of ROP.
Babies who have or develop severe ROP may benefit from a treatment called cryotherapy that uses freezing to prevent further damage. Uses of laser photocoagulation to create small burns and scar tissue is another treatment option. These scars seal the edges of the retina and help prevent detachment. Other treatments for more severe cases of ROP are scleral cerclage and vitrectomy. The scleral cerclage is a silicone band that is placed around the eye to prevent vitreous humor in the eye from pulling the scar tissue. This allows the retina to remain flat.
Prevention of retinopathy of prematurity
The key to preventing ROP is to avoid premature births. Even so, research is ongoing to find ways to treat this and other problems of premature babies.
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