Retinopathy of Prematurity, is my baby at risk?

Retinopathy of Prematurity, or ROP, is a disease only found in premature infants.  It is a potentially blinding disease caused by an abnormal development of the blood vessels in the back lining of the eye, called the retina.  Most ROP resolves on its own but in its severe form, the retina can detach, causing blindness.

There are approximately 4 million babies born in the United States each year.  Of that number, approximately 14,000 have ROP.  About 1,500 babies require treatment and between 400 and 600 babies go blind from this disease.  The babies with the highest risk are those with severely low birth weight who are born very early.  All babies that are 32 weeks and younger and those that are 1500 grams or lower are examined.

Retinopathy of Prematurity is usually diagnosed with a thorough dilated exam by either a Pediatric Ophthalmologist or Retinologist.  It is graded into 5 stages and 3 zones.  The higher the stage and the lower the zone, the more severe.  Stage 4 and 5 are partial and total retinal detachments.  That is what we try to avoid.  If the vessels are tortuous, it is called “plus disease.”  These babies are at great risk as well.  When babies reach “Type 1” disease, which is zone 1 disease with plus, zone 1 disease with stage 3, or zone 2 stage 2-3 with plus, there is enough risk of retinal detachment that treatment is warranted.

The treatment for ROP involves laser to the periphery of the retina.  For the sicker children, there are now injections that babies can have that also help decrease the risk of progression toward retinal detachment.

Once Retinopathy of Prematurity is diagnosed, it is extremely important to have timely exams by a Pediatric Ophthalmologist.  Once stage 1 is diagnosed, usually patients are seen every 2-3 weeks.  If too much time goes by, the disease may progress unnoticed.  When discharged from the hospital, it is important to determine when the last eye exam so a follow-up appointment can be made.  One Type 1 ROP is diagnosed, a baby needs to be treated within 72 hours.

If your child is premature and needs to be evaluate, please do not hesitate to call and emphasize the need for a timely appointment.

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