Retinopathy of prematurity

Abstract

This review deals with retinopathy of prematurity (ROP), a disease characterized by retinovitreal neovascularization, eventually retinal detachment and blindness. Due to the increasing number of extremely premature newborns, it is becoming more frequent. ROP of all stages occurs in 25-35% of surviving premature newborns of gestational age up to approximately 35 weeks. Stages 3 or more occur in 5-10%, blindness in 3-5% of very immature babies. The incidence is inversely related to gestational age. Classification is internationally unified (ICROP) and describes 5 stages. Its pathogenesis has not yet been clarified. More or less proven risk factors are retinovascular immaturity, hyperoxia and possibly circulatory and respiratory instability. Prophylaxis consists in avoiding hyperoxia, and probably also in keeping the extremely premature newborn stable. Ophthalmologic examinations must be performed by ophthalmologists experienced in this field or under their direct responsibility and must be standardized. Treatment of ROP can be carried out at a certain stage by coagulation therapy.

The Effect of Anemia on Retinopathy of Prematurity in Extremely Low Birth Weight Infants

“…However, there is speculation that transfusions containing adult hemoglobin with its lower affinity for oxygen than fetal hemoglobin F cause greater oxygen delivery to the retina, increasing the risk for developing ROP. 2 In addition, packed red blood cell transfusions contain large amounts of iron, which can rapidly increase serum iron levels in premature infants. Free iron can produce free radicals, which have been enzymatically linked to ROP development.…”

“…6 Numerous retrospective studies have examined potential risk factors contributing to development of ROP. These have included low gestational age at birth, 7 ± 12 low birth weight, 5,10,12 ± 14 male sex, 9 white race, 12,15 bronchopulmonary dysplasia, 5,10,13,16 sepsis, 8,13 acidosis, 7,11,16 oxygen therapy, 14,17 hyperoxia, 2,11,18 hypocarbia, 19 hypoxia, 1,11,19 and maternal use of beta blockers immediately before birth. 14 Recently, a case of neonatal HIV infection after blood transfusion at another institution led to a decrease in blood transfusions in premature infants at that hospital.…”

Threshold Stage of Retinopathy of Prematurity: Maternal and Neonatal Risk Factors

“…Retinopathy of prematurity (ROP) is a disorder of the blood vessels in the developing retina of premature infants, [1][2][3] and is one of the major causes of blindness and impaired vision among children. 1,2,4,5 Since many premature and extremely low birth weight babies survive, the disease has become a challenge to neonatologists and ophthalmologists.…”

“…1,2,4,5 Since many premature and extremely low birth weight babies survive, the disease has become a challenge to neonatologists and ophthalmologists. The incidence varies in different neonatal units, 3,[6][7][8][9][10][11][12][13] and low birth weight has been the only risk factor uniformly identified.…”

“…The incidence varies in different neonatal units, 3,[6][7][8][9][10][11][12][13] and low birth weight has been the only risk factor uniformly identified. 1,3,4,[6][7][8][9][10][11][13][14][15][16][17] The rate of the threshold form of the disease has been measured in different neonatal units, 6,7,9,13 however, its association with risk factors has not been fully identified. We present the rate of and risk factors associated with the threshold stage of ROP in a cohort of preterm babies born in our units over a two-year period.…”