ROP – Retinopathy of Prematurity

Retinopathy of prematurity (ROP), also known as Retrolental Fibroplasia, is an eye disease that affects babies born in preterm. It is characterized by the abnormal development of the small blood vessels in the retina of the eye of a premature infant.

The blood vessels of the retina of a baby's eye begins its development three months after the baby is conceived and the development will be completed at the time of normal birth. So when a baby is born prematurely, this will caused a disruption, either the blood vessels will stop growing or grow abnormally from the retina into the normally clear gel that fills the back of the eye. Because the vessels are fragile, they can leak and cause the bleeding in the eye. The abnormal growth of the blood vessels may also lead to the development of scar tissue and cause the retina to be pulled loose from the inner surface of the eye. Severe cases of ROP may cause the infant its vision.

Previously, the excess oxygen which is used to treat premature babies is believed to stimulate the abnormal growth of the vessels. However, technology has allowed for the easy and accurate monitoring of the oxygen so the situation is unlikely to happen unless there is negligence. Aside from being born prematurely, other risk factors for ROP include:

• Low birth weight
• Apnea
• Heart disease
• Presence of high levels of carbon dioxide (CO2) in the blood
• Infection
• Low blood acidity (pH)
• Low blood oxygen
• Respiratory distress
• Bradycardia
• Transfusions

ROP has five stages. Stage I is characterized by a mild abnormal growth of the blood vessel; and Stage II exhibits a moderate abnormality on the blood vessels growth. Most infants suffering from stage I and II require no treatment though as they will improve on their own and will later on develop a normal vision. Stage III, on the other, has the abnormal growth of the blood vessels in a severe case. Some children diagnosed in this stage progress to what is known as the "plus disease" stage, a particular degree of this stage in which the retinal blood vessels appear enlarged and twisted. In Stage IV, aside from the severity, the retina is partially detached while in Stage V, there is total retinal detachment.

If not treated at this stage, the baby will suffer from severe visual impairment or may even become blind.

A baby is also said to have severe ROP if he or she is having abnormal eye movements, crossed eyes, severe nearsightedness and white-looking pupils or leukocoria.

Considered a highly effective treatment for ROP are laser therapy or cryotherapy. In laser therapy, the peripheral area of the retina and its abnormal blood vessels are burned while in cryotherapy, an instrument with freezing temperatures is used to briefly touch spots on the eye's surface that lie over the periphery of the retina. Both methods destroy the peripheral areas of the retina and should only be used on children diagnosed with advanced ROP.