Retinopathy of Prematurity

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Overview

Retinopathy of prematurity or ROP (formerly known as retrolental fibroplasia) is the abnormal growth of blood vessels within the retina and vitreous that occurs in some premature infants.

Abnormal blood vessel growth (neovascularization) does not deliver nutrients to the retina; rather, it is associated with significant disease as the blood vessels are fragile and prone to leak. The progression to later stages of ROP can lead to the formation of scar tissue on the retina, vitreous hemorrhage, and retinal detachment.

Many infants who have early ROP improve spontaneously. The severity of ROP varies, ranging from nearly normal vision to total blindness. Signs of ROP are found in very premature babies and one in ten progresses to more severe stages. Typically, the smallest and earliest premature babies are at the highest risk for developing ROP.

Incidence and Prevalence
More than 80% of premature babies who weigh less than 1000 grams (2.2 lbs.) develop ROP. The incidence of ROP is rising because of the medical profession's ability to improve survival rates among the most premature babies.

Risk Factors

The greatest risk factor is prematurity, particularly at 32 weeks gestation or less. Low birth weight (1500 grams or lower) also increases the risk. Other risk factors include the following:

• Duration of intubation
• Intraventricular hemorrhage (bleeding into the ventricles of the brain)
• Multiple prenatal maternal factors (e.g., diabetes, preeclampsia, heavy smoking, inadequate oxygen supply to the fetus)
• Respiratory distress syndrome
• Sepsis (i.e., infection in the blood or other tissues)
• Vitamin E deficiency

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