Retinopathy of Prematurity
Retinopathy of prematurity is a disease in which the small blood vessels in the back of the eye (retina) grow abnormally.
In newborns born very prematurely, growth of the blood vessels supplying the retina may stop for a period of time. When growth resumes, it occurs in a disorganized fashion. During disorganized rapid growth, the small blood vessels may bleed and eventually lead to scarring. In the most severe cases, this process may ultimately result in detachment of the retina from the back of the eye and loss of vision. High blood oxygen levels may also increase the risk of retinopathy of prematurity.
The newborn who is developing retinopathy of prematurity does not have symptoms, and diagnosis depends on careful examination of the back of the eyes by an eye specialist (ophthalmologist). Routinely, therefore, an ophthalmologist examines the eyes of premature newborns who weigh less than 1,500 grams at birth starting 4 or more weeks after delivery. Eye examinations are repeated every 1 to 2 weeks as needed, until growth of the blood vessels in the retina is complete. Infants who develop severe retinopathy must have eye examinations, at least yearly, for the rest of their lives. If detected early, retinal detachment can occasionally be treated to avoid complete loss of vision in the affected eye.
Prevention, Treatment, and Prognosis
In a premature newborn who needs oxygen, the oxygen use is monitored carefully to prevent excessive oxygen levels in the blood that would put the newborn at increased risk of retinopathy of prematurity. Alternatively, the oxygen levels can be indirectly monitored using a pulse oximeter, which measures the level of oxygen in the blood going through a finger or toe.
Retinopathy is usually mild and resolves spontaneously, but the eyes need to be monitored by an ophthalmologist until blood vessel growth is mature.
For very severe retinopathy of prematurity, laser treatment is applied to the outermost portions of the retina. This treatment stops the abnormal growth of blood vessels and decreases the risk of retinal detachment and loss of vision.
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