Dr. Maneesh Bapaye
Dr. Bapaye Hospital, Nashik
Retinopathy of prematurity (ROP) is an eye disorder that affects premature infants. It occurs when the blood vessels that supply the retina, the part of the eye that detects light, grow abnormally. ROP can cause vision loss and even blindness if left untreated.
There are several risk factors for ROP, including premature birth (born before 36 weeks), low birth weight (less than 1500 grams), respiratory distress syndrome, prolonged use of oxygen therapy, and multiple births (twins, triplets, etc.). Premature infants who have one or more of these risk factors are more likely to develop ROP.
ROP is classified into five stages based on the severity of the condition. Stage 1 ROP is the mildest form and is characterized by a thin white line in the retina. Stage 2 ROP involves the growth of abnormal blood vessels, while stage 3 ROP is characterized by the growth of blood vessels that extend into the vitreous gel in the center of the eye. In stage 4 ROP, the abnormal blood vessels cause the retina to detach from the back of the eye. Stage 5 ROP is the most severe form and involves total retinal detachment, which can cause permanent vision loss.
To prevent vision loss from ROP, premature infants are screened for the condition starting at 4-6 weeks of age, or earlier if they are at high risk. The screening schedule varies depending on the infant’s gestational age and the severity of the ROP. The screening exam involves dilating the pupil and examining the retina using an indirect ophthalmoscope, which is a special type of microscope that allows the doctor to see the back of the eye. The examination is done without any aneathesia to avoid its complications. The baby may cry during examination and eyes might appear a bit swollen and red after 1-2 days after examination.
If ROP is detected, the treatment will depend on the severity of the condition. In some cases, the ROP may resolve on its own without treatment. In other cases, treatment may be necessary to prevent vision loss. The three main treatment methods for ROP are laser therapy, AntiVEGF injections, and surgery.
Laser therapy, also known as photocoagulation, involves using a laser to destroy the abnormal blood vessels in the retina. The laser creates small burns that cause the abnormal blood vessels to shrink and disappear. Laser therapy is usually performed on infants with stage 3 ROP or more severe forms of the condition.
AntiVEGF injections involve injecting a medication called bevacizumab into the vitreous gel in the center of the eye. Bevacizumab blocks a protein called VEGF, which is responsible for the growth of abnormal blood vessels in the retina. AntiVEGF injections are usually used as a first-line treatment for infants with severe ROP.
Surgery may be necessary if the ROP has caused a retinal detachment. The surgery involves reattaching the retina to the back of the eye using a procedure called scleral buckling. During scleral buckling, a silicone band is placed around the eye to push the retina back into place. Surgery is usually reserved for infants with stage 4 or 5 ROP.
In conclusion, ROP is a serious eye disorder that affects premature infants. Screening and early detection are crucial for preventing vision loss and blindness. Treatment options include laser therapy, AntiVEGF injections, and surgery, depending on the severity of the condition. It’s important for parents and healthcare providers to be aware of the risk factors for ROP and to follow the recommended screening schedule to ensure the best possible outcomes for infants at risk.
Address: Dr. Bapaye Hospital, Behind NDCC Bank, Opposite Hotel Samrat, Old Agra Road, Near CBS, Nashik 422001
Phone 0253-2506505/2509421
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