Summary about Disease
Retinopathy of Prematurity (ROP) is an eye disease that can occur in premature babies. It happens when abnormal blood vessels grow in the retina, the light-sensitive tissue at the back of the eye. These abnormal vessels can leak and scar the retina, potentially leading to vision loss or blindness. ROP is a leading cause of childhood blindness.
Symptoms
In the early stages, ROP usually has no visible symptoms. As ROP progresses, symptoms might include:
Abnormal blood vessel growth in the retina (detectable only through eye exams)
Clouding of the lens
White or yellowish appearance of the pupil (in severe cases)
Nystagmus (involuntary eye movements)
Poor vision or blindness
Causes
The primary cause of ROP is premature birth. Premature babies have incomplete blood vessel development in their retinas. After birth, if the baby is exposed to high oxygen levels (though this is not always the sole cause), it can disrupt normal blood vessel growth. When the oxygen levels stabilize, the normal vessel growth might be stunted. This can lead to abnormal vessels forming in the attempt to compensate. Other contributing factors include:
Low birth weight
Anemia
Blood transfusions
Respiratory distress
Infection
Medicine Used
Anti-VEGF (Vascular Endothelial Growth Factor) Injections: Medications like bevacizumab (Avastin), ranibizumab (Lucentis), and aflibercept (Eylea) are injected directly into the eye to stop the growth of abnormal blood vessels.
Laser Therapy (Photocoagulation): Uses a laser to destroy the peripheral retinal area that is not well vascularized to reduce the drive for abnormal vessel growth.
Is Communicable
No, Retinopathy of Prematurity is not a communicable disease. It is not contagious and cannot be spread from person to person.
Precautions
The following precautions can help to minimize the risk of ROP:
Preventing Premature Birth: Good prenatal care is crucial.
Controlled Oxygen Administration: Carefully monitor and regulate oxygen levels given to premature infants.
Regular Eye Exams: Premature infants should have regular eye exams by an ophthalmologist experienced in ROP screening.
Management of Other Health Conditions: Closely manage other health problems common in premature infants, such as anemia and respiratory distress.
How long does an outbreak last?
ROP is not an "outbreak" in the traditional sense of an infectious disease. The active phase of ROP, where abnormal blood vessel growth occurs, typically lasts several weeks to months. The disease may resolve spontaneously in some cases, while in others, it can progress to more severe stages requiring treatment. If treated successfully, the progression can be halted.
How is it diagnosed?
ROP is diagnosed through a dilated eye exam performed by an ophthalmologist, typically a retina specialist, who is experienced in examining premature infants. The ophthalmologist uses an ophthalmoscope to view the retina and look for signs of abnormal blood vessel growth, staging of the disease, and other retinal abnormalities.
Timeline of Symptoms
Early Stages (Stage 1 & 2): Often asymptomatic and only detectable through an eye exam. The ophthalmologist notes subtle changes in blood vessel development.
Progressive Stages (Stage 3): Abnormal blood vessels begin to grow (neovascularization). Still generally no external symptoms.
Advanced Stages (Stage 4 & 5): Retinal detachment occurs. This can lead to decreased vision, nystagmus, or even blindness. The pupil may appear white (leukocoria).
Timeframe: ROP screening typically starts around 4-6 weeks after birth or 30-32 weeks gestational age, depending on the baby's birth weight and gestational age. Progression can be rapid, so frequent monitoring is essential.
Important Considerations
Early detection and timely treatment are critical for preventing vision loss in ROP.
Parental involvement is essential. Parents should be educated about ROP and the importance of follow-up eye exams.
Even with treatment, some children with ROP may develop long-term vision problems.
A multidisciplinary approach, involving neonatologists, nurses, and ophthalmologists, is important for the management of ROP.
Screening guidelines are specific to gestational age and birthweight, following national/international protocols.