Retinopathy of Prematurity

Retinopathy of Prematurity

What is retinopathy of prematurity? — Retinopathy of prematurity (also called "ROP") is an eye condition that happens in babies who are born very early or are very small. In ROP, extra blood vessels grow inside the eye. They can damage the tissue at the back of the eye, called the "retina" (figure 1). This part of the eye contains the cells that react to light. Damage to the retina can cause vision problems and even blindness.
ROP usually goes away as a baby grows. But if ROP is severe, a baby might need treatment.
What are the symptoms of ROP? — ROP does not usually cause symptoms. But if a baby is born very early or is very small, doctors will check for signs of ROP.
Is there a test for ROP? — Yes. An eye doctor with special training in caring for newborn babies can do an exam to check for ROP. A baby might not need this exam until he or she is 4 to 8 weeks old.
After the first exam, an eye doctor will probably check your baby's eyes every 1 to 3 weeks. He or she can check to see if the ROP is getting worse or better. If it gets worse, your baby might need treatment.
Some hospitals check for ROP by taking pictures of the baby's eyes. The pictures are then sent electronically to an eye doctor who can tell if there are signs of ROP.
How is ROP treated? — Some babies do not need any treatment for ROP. But severe ROP needs treatment. If severe ROP is not treated, it can cause blindness.
There are two procedures that doctors can use to treat ROP:
"Photocoagulation" – This treatment uses a powerful light called a "laser" to seal or destroy the extra blood vessels. Babies often need general anesthesia for this procedure. This involves giving medicine to put the baby to sleep so he or she won't feel anything during the procedure.
Anti-VEGF injection – This treatment involves injecting the eye with special medicines called "anti-VEGF" drugs. These medicines stop the extra blood vessels from growing. Most babies don't need general anesthesia for this procedure. The doctor uses a numbing medicine on the eye before the injection.
The decision of which procedure is used will depend on your baby's condition and how severe the ROP is. Your doctor will talk to you about which procedure is right for your baby.
Sometimes, ROP pulls the retina out of its normal place in the eye. When this happens, it is called a "retinal detachment." Doctors can do surgery to try to put the retina back in place. But there might be too much damage for surgery to fix it completely. If this happens to your baby, he or she might not see well from that eye.
Can ROP be prevented? — Right now, doctors do not have a good way to keep babies from getting ROP. Feeding your baby breast milk can help protect him or her from getting ROP. Breast milk has other benefits for babies, too.
If your baby needs eye exams to check for ROP, make sure you go to all the appointments. If you do this, your baby can get treatment for ROP if he or she needs it.
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This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 83444 Version 6.0
Release: 28.2.2 - C28.105
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