Retinopathy of prematurity

Overview & Definition

Retinopathy of prematurity (ROP) is a disorder of the developing retinal blood vessels in which the immature, incompletely vascularised retina grows abnormal new vessels that can scar, contract, and detach. It is the leading cause of preventable childhood blindness in high-income countries, and it is entirely a disease of prematurity: the more immature the infant, greater risk ^[7].

The crucial clinical point is that ROP is silent at the bedside. An infant can be growing, weaning from oxygen, and outwardly well while sight-threatening disease develops silently in the periphery of the retina. For this reason, ROP is not a diagnosis made from symptoms or vital signs. It is found only by scheduled retinal examination of infants who are at risk by virtue of gestational age and birth weight, and the entire purpose of a screening programme is to detect and treat the disease before it reaches the point of irreversible retinal detachment ^[6].

Classification is governed worldwide by the International Classification of Retinopathy of Prematurity, now in its third edition (ICROP-3), which standardises how every eye is described by three axes — zone, stage, and the presence of plus disease ^[1].

References11ShowHide

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