What You Should Know About Retinopathy of Prematurity
Retinopathy of prematurity (ROP) is a progressive retinal condition that can occur in babies who are born prematurely. In ROP, abnormal neovascularization (i.e., the growth of new blood vessels) occurs in the infant’s retina, typically in both eyes. These blood vessels are extremely fragile, break easily, and grow in atypical ways. As with other retinal vascular diseases, this can lead to bleeding and leakage in the retina and macula.
In its earliest stages, ROP neovascularization tends to be minimal and, in some cases, doesn’t necessarily require treatment. However, as time goes on and the disease continues to progress, new blood vessel growth can accelerate and become increasingly problematic. In the most severe, advanced stages of ROP, hemorrhaging in the vitreous humor (the gel-like liquid that fills the eye) can result in a partially or fully detached retina, which can potentially lead to permanent vision loss.
What Causes ROP?
During the first trimester of pregnancy, an embryo develops at a rapid rate, transforming from a single-celled zygote into a fetus within a matter of weeks. Between the fifth and eighth weeks of development, the fetus’s eyes extend from the brain and form into their own structures. The retina, along with the cornea, pupil, iris, and lens, becomes fully formed after a couple of weeks. At about 16 weeks, retinal blood vessels will begin to form, and they will continue to develop through the full term of the pregnancy.
However, this development is interrupted when babies are born prematurely, which can lead to abnormal neovascularization. When babies are born before 32 weeks, they are at a higher risk of developing ROP. This is especially true if the baby weighs less than 3.3 lbs. Babies who are born prematurely are generally immediately placed in the hospital’s neonatal intensive care unit, or NICU, where they are monitored for a wide range of health factors, including vision. While a baby is in the NICU, an ophthalmologist performs a thorough eye exam to determine whether or not an infant has ROP. If it’s determined that the infant has ROP, the parents of the child will be referred to a retina specialist for further care.
What Are the Symptoms of ROP?
In mild cases of ROP, an infant may not exhibit any symptoms. However, if an infant or child exhibits the following symptoms, it typically indicates a severe case of ROP:
- Irregular eye movements
- Extreme myopia (nearsightedness)
- Strabismus (crossed eyes)
- Leukocoria (white discoloration of the pupil)
- Problems responding to light
How Is ROP Treated?
In mild cases of ROP, treatment outside of regular screenings may not be recommended until the disease progresses. As ROP becomes more advanced, retina specialists typically recommend laser photocoagulation, which is the current standard of treatment for ROP. Laser photocoagulation is used to burn the edges of the peripheral retina to create scar tissue, which helps protect the retina from abnormal blood vessels, bleeding, and leakage. In many cases, it also prevents retinal detachment from occurring.
ROP is also sometimes treated with intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF) medications. This type of treatment helps reduce abnormal blood vessel growth by inhibiting the protein responsible for the formation of new blood vessels.
The only way ROP can possibly be prevented is by taking action to prevent premature births. Pregnant mothers can reduce their risk for having a premature birth by avoiding tobacco (as well as secondhand smoke and vaping), avoiding alcohol, eating a healthy diet containing folic acid, and discussing with their OB/GYN any risk factors they may have that can contribute to premature birth.
Advanced Retinal Care for ROP in New York
With proper monitoring and treatment, many babies with ROP have improved chances of retaining their vision. If you are the parent of a preterm baby who has been diagnosed with retinopathy of prematurity and are looking for advanced pediatric retinal care in Long Island or Queens, NY, please contact Vitreoretinal Consultants of New York today.