Stage 5 retinopathy of prematurity: An update

Abstract

Retinopathy of prematurity (ROP) is one of the most common causes of preventable blindness in children. In spite of the availability of various treatment options, and favorable results with timely intervention, many infants present to the ophthalmologists in the advanced end stage of the disease due to lack of awareness especially in the developing nations. This blinding or Stage 5 of ROP presents with total retinal detachment and has to be managed surgically. The surgical techniques for Stage 5 ROP are unique and demanding. The successful anatomical results after surgery are only seen in 20%–50% of cases. In spite of a successful anatomical result, the visual outcome may be slow and limited. The use of newer pharmacological adjuncts has shown promising results. Because of heterogeneity of presentation of the disease severity, a genetic predisposition has also been proposed. A concerted effort from the pediatricians, ophthalmologists, and healthcare workers is required to establish effective screening and treatment guidelines to prevent blindness due to ROP. Till then surgical management has to be done. Parents must be educated regarding the limited visual benefits of surgery and the need for prolonged follow-up. This review gives a comprehensive overview of the pathogenesis, clinical aspects, surgical interventions, and their outcomes and future prospects of Stage 5 ROP.

Neonatal Intensive Care Unit-based screening program for retinopathy of prematurity and its treatment in an Indian population

“…[101112] Vinekar et al [13] suggested different scenarios of ROP screening in developing countries such as India. Sen et al [2] and Jalali et al [5] suggested that all infants in India with birth weight <1700 g and gestational age <34–35 weeks should be screened regularly. The rate of favorable outcome and a posterior location of the disease are inversely related.…”

“…Now, because of improved neonatal survival rate, the incidence of ROP is increasing in India, which is between 38% and 51.9% in preterm infants. [2] Today, it is well known that oxygen therapy is not the single causative factor, but several other risk factors also play a role in the pathogenesis of ROP. [3] Although current ablation treatments can reduce the incidence of blindness by approximately 25% in infants with advanced ROP, the patients often still have poor visual acuity even after treatment and the life-long impact of the disease on eye and vision development remains significant.…”

Perbandingan Hispatologi Neovascular Tuft pada Retina Tikus yang Mengalami Oxygen-Induced Retinopathy dengan dan tanpa Pemberian L-Carnitine

“…4 Insidens ROP di India juga meningkat, dari 26 juta kelahiran/ tahun, sebanyak 2 juta merupakan bayi dengan berat lahir <2.000 gram yang berisiko ROP sekitar 38-51,9%. 5 Data di Indonesia diperoleh angka kejadian kelahiran prematur pada bayi lahir hidup di RS Cipto Mangunkusumo tahun 2007 adalah 20,22% dan sebanyak 71% kasus mengalami ROP. 6 Penelitian dalam mempelajari ROP pada manusia telah banyak dilakukan pada hewan coba.…”

Features of the Anterior Segment of the Eyeball in Children with 5 Cicatricial Retinopathy of Prematurity According to Ultrasound Biomicroscopy and Optical Coherent Tomography

“…Несмотря на то что основное внимание в отечественной и зарубежной литературе абсолютно правомерно уделено вопросам мониторинга и лечения ранних активных форм РН как потенциально значимых для формирования наилучшего анатомического и функционального результата [1][2][3][4], по-прежнему в своей практике офтальмологи встречаются с далеко зашедшими стадиями заболевания (4б, 5-я стадия) [5,6]. При их развитии формируются структурные изменения не только задних отделов глаза, но и существенно изменяется анатомия переднего отрезка.…”