Importance of Retinopathy of Prematurity (ROP) Screening

What is ROP?

Retinopathy of prematurity (ROP) is a disorder associated with the developing retina in less birth weight premature babies that may sometimes end in blindness. In most of the normal babies, the retina and retinal vasculature seems to be developed fully leaving no chance for ROP. However, in preterm babies, the retinal development remains incomplete as the baby does not cross the normal gestational weeks of development.

The level of immaturity of retina depends on the degree of babys prematurity during birth. Babies who are 1250 g or less in birth weight and born before 31 gestational weeks are subjected to highest risk of ROP. Most ROP cases resolve without damaging the retina, but if ROP seems to be severe, it may lead to pulling off or detachment of retina from the eye wall and probably causing blindness.

Factors Increasing the Risk of ROP

Gestational age and birth weight are the two main factors deciding the severity of ROP. Few other factors contributing for the cause of ROP include very less weight gain of foetus, anaemia, blood transfusion, breathing difficulties, respiratory distress and infants overall health.

ROP Stages with Probable Outcomes

Stage I

Mild abnormal growth of blood vesselthroughout the retina; children at stage I may improve without treatment and get normal vision.

Stage II

Moderate abnormal growth of blood vessel throughout the retina; children at stage II may improve without treatment and finally end with normal vision.

Stage III

Severe growth of abnormal blood vessel towards the centre of eye rather than the surface of the retina. Few infants at stage III improve without treatment and attain normal vision. However, plus disease with Stage III may lead to retinaldetachment, if not treated at the right time.

Stage IV

Partial detachment of retina; abnormal vessels pulls away the retina from the eye wall.

Stage V

Fully detached retina and the final stage of ROP. If not treated, the infant can face visual impairment and eventuallyblindness.

Diagnosis of ROP

Ophthalmologists, eye specialists at Nyle Hospital are very much skilled in evaluating babies eyes for the presence of ROP. Generally, the evaluation is done after dilating the pupils with eye drops specially used for this purpose. Research is still under progress to evaluate the accuracy of digital photography in diagnosing ROP. All infants who are 1500 g (3.3 lbs) or less in birth weight or born before completion of 31 weeks are suggested to carry out eye examination compulsorily to detect the stage of ROP.

Screening is must for

  • Babies with GA of 26 6/7 weeks or less at birth initial screening at 31 weeks PMA
  • Babies with GA of 27 weeks or more at birth initial screening at 4 weeks CA

    Responsibilities of the Hospital in ROP Screening

    • All hospitals providing care for newborns against the risk of ROP must guaranty t for accurate ROP screening.
    • ROP screening results must be evaluated and documented before communicating it to parents. Parents of severe ROP babies must be informed about the chances of visual impairment.
    • Before discharging the little patient, parents should be indicated and explained about the importance of ophthalmological examinations and subsequent medications.