Retinopathy of Prematurity

 

Retinopathy of prematurity is a bilateral disease of the retinal vessels present in premature infants, some of whom were exposed to high postnatal oxygen concentrations.  High oxygen concentration used in treating premature infants, esp. those weighing less than 1500 grams, causes vasoconstriction of the immature retinal vessels and eventually occlusion of the vessels.  Fibrous proliferation and invasion of the vitreous may follow this.  Retinal detachment may occur at that time or many years later.  Blindness develops within several weeks.  Other factors can gave an important role in the pathogenesis of retinopathy of prematurity (ROP).  Apnea, asphyxia, sepsis, nutritional deficiencies, and a large number of blood transfusions given over a short period of time have all been related to ROP.

          Prevention is possible by using only the lowest possible effective oxygen concentration in treating premature infants.  Thus, the lowest level possible without endangering the life of the infant is used.  Too severe restriction of oxygen will increase the likelihood of hyaline membrane disease and neurologic disorders.  All premature infants treated with supplemental oxygen should have careful examination by an ophthalmologist prior to discharge from the hospital.  Once blindness develops, there is no effective treatment.