Retinopathy of Prematurity
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Retinopathy of prematurity (ROP) occurs due to abnormal proliferation of retinal vessels. The most important risk factors which predispose to development of ROP include oxygen therapy, anemia needing blood transfusion, sepsis and apnea. Very low birth weight neonates, those born at ≤32 week of gestation and other preterm neonates with risk factors must be screened for ROP. As a general rule first screening should be done at 1 month of postnatal age. If screening detects ROP not needing treatment follow up should be planned according to location and stage of ROP. Better visual outcomes are observed with earlier treatment at lower threshold. Peripheral retinal ablation with diode laser under adequate analgesia and sedation is the preferred method for treatment of severe ROP. Guidelines regarding the procedure of dilatation, ophthalmic examination and treatment (if required) have been provided in the protocol. Close co-operation between the ophthalmologist and neonatologist is essential for successful management of ROP.
- Flynn, JT (1992) The premature retina: a model for the in vivo study of molecular genetics?. Eye 6: pp. 161-165 CrossRef
- Kushner, BJ, Essner, D, Cohen, IJ, Flynn, JT (1977) Retrolental fibroplasia II. Pathologic correlation. Arch Ophthalmol 95: pp. 29-38 CrossRef
- Chan-Ling, T, Tout, S, Hollander, H, Stone, J (1992) Vascular changes and their mechanisms in the feline model of retinopathy of prematurity. Invest Ophthalmol Vis Sci 33: pp. 2128-2147
- Chan-Ling, T, Gock, B, Stone, J (1995) The effect of oxygen on vasoformative cell division. Evidence that ‘physiological hypoxia’ is the stimulus for normal retinal vasculogenesis. Invest Ophthalmol Vis Sci 36: pp. 1201-1214
- Chaudhari, S, Patwardhan, V, Vaidya, U, Kadam, S, Kamat, A (2009) Retinopathy of prematurity in a tertiary care center—incidence, risk factors and outcome. Indian Pediatr 46: pp. 219-224
- Charan, R, Dogra, MR, Gupta, A, Narang, A (1995) The incidence of retinopathy of prematurity in a neonatal care unit. Indian J Ophthalmol 43: pp. 123-126
- Gupta, VP, Dhaliwal, U, Sharma, R, Gupta, P, Rohatgi, J (2004) Retinopathy of prematurity—risk factors. Indian J Pediatr 71: pp. 887-892 CrossRef
- Maheshwari, R, Kumar, H, Paul, VK, Singh, M, Deorari, AK, Tiwari, HK (1996) Incidence and risk factors of retinopathy of prematurity in a tertiary care newborn unit in New Delhi. Natl Med J India 9: pp. 211-214
- Aggarwal, R, Deorari, AK, Azad, RV (2002) Changing profile of retinopathy of prematurity. J Trop Pediatr 48: pp. 239-242 CrossRef
- Dutta, S, Narang, S, Narang, A, Dogra, M, Gupta, A (2004) Risk factors of threshold retinopathy of prematurity. Indian Pediatr 41: pp. 665-671
- Rekha, S, Battu, RR (1996) Retinopathy of prematurity: incidence and risk factors. Indian Pediatr 33: pp. 999-1003
- Gopal, L, Sharma, T, Ramachandran, S, Shanmugasundaram, R, Asha, V (1995) Retinopathy of prematurity: a study. Indian J Ophthalmol 43: pp. 59-61
- Varughese, S, Jain, S, Gupta, N, Singh, S, Tyagi, V, Puliyel, JM (2001) Magnitude of the problem of retinopathy of prematurity. experience in a large maternity unit with a medium size level-3 nursery. Indian J Ophthalmol 49: pp. 187-188
- Sharma P. DM dissertation: Risk factors for severe retinopathy of prematurity in preterm low birth weight neonates Department of Pediatrics. New Delhi: All India Institute of Medical Sciences 2009 (Submitted for publication to Indian Journal of Pediatrics).
- Saunders, RA, Donahue, ML, Christmann, LM (1997) Racial variation in retinopathy of prematurity. The cryotherapy for retinopathy of prematurity cooperative group. Arch Ophthalmol 115: pp. 604-608 CrossRef
- Hellstrom, A, Hard, AL, Engstrom, E (2009) Early weight gain predicts retinopathy in preterm infants: new, simple, efficient approach to screening. Pediatrics 123: pp. e638-e645 CrossRef
- Hellstrom A, Ley D, Hansen-Pupp I, et al. New insights into the development of retinopathy of prematurity—importance of early weight gain. Acta Paediatr 2010;99:502–8.
- The International Classification of Retinopathy of Prematurity revisited. Arch Ophthalmol. 2005;123:991–99.
- Azad, R, Chandra, P, Patwardhan, SD, Gupta, A (2009) Importance of the ‘third criterion’ for retinopathy of prematurity screening in developing countries. J Pediatr Ophthalmol Strabismus 46: pp. 332-334 CrossRef
- Screening examination of premature infants for retinopathy of prematurity. Pediatrics. 2006;117:572–576.
- Sun, X, Lemyre, B, Barrowman, N, O’Connor, M (2010) Pain management during eye examinations for retinopathy of prematurity in preterm infants: a systematic review. Acta Paediatr 99: pp. 329-334 CrossRef
- Kemper, AR, Wallace, DK, Quinn, GE (2008) Systematic review of digital imaging screening strategies for retinopathy of prematurity. Pediatrics 122: pp. 825-830 CrossRef
- Revised indications for the treatment of retinopathy of prematurity: results of the early treatment for retinopathy of prematurity randomized trial. Arch Ophthalmol 121: pp. 1684-1694 CrossRef
- Finer, N, Leone, T (2009) Oxygen saturation monitoring for the preterm infant: the evidence basis for current practice. Pediatr Res 65: pp. 375-380 CrossRef
- Flynn, JT, Bancalari, E, Snyder, ES (1992) A cohort study of transcutaneous oxygen tension and the incidence and severity of retinopathy of prematurity. N Engl J Med 326: pp. 1050-1054 CrossRef
- Castillo, A, Sola, A, Baquero, H (2008) Pulse oxygen saturation levels and arterial oxygen tension values in newborns receiving oxygen therapy in the neonatal intensive care unit: is 85% to 93% an acceptable range?. Pediatrics 121: pp. 882-889 CrossRef
- Tin, W, Milligan, DW, Pennefather, P, Hey, E (2001) Pulse oximetry, severe retinopathy, and outcome at one year in babies of less than 28 weeks gestation. Arch Dis Child Fetal Neonatal Ed 84: pp. F106-F110 CrossRef
- Chow, LC, Wright, KW, Sola, A (2003) Can changes in clinical practice decrease the incidence of severe retinopathy of prematurity in very low birth weight infants?. Pediatrics 111: pp. 339-345 CrossRef
- Askie, LM, Henderson-Smart, DJ, Irwig, L, Simpson, JM (2003) Oxygen-saturation targets and outcomes in extremely preterm infants. N Engl J Med 349: pp. 959-967 CrossRef
- Supplemental Therapeutic Oxygen for Prethreshold Retinopathy Of Prematurity (STOP-ROP), a randomized, controlled trial. I: primary outcomes. Pediatrics. 2000;105:295–310.
- Brion LP, Bell EF, Raghuveer TS. Vitamin E supplementation for prevention of morbidity and mortality in preterm infants. Cochrane Database Syst Rev. 2003:CD003665.
- Micieli, JA, Surkont, M, Smith, AF (2009) A systematic analysis of the off-label use of bevacizumab for severe retinopathy of prematurity. Am J Ophthalmol 148: pp. 536-543 CrossRef
- Retinopathy of Prematurity
The Indian Journal of Pediatrics
Volume 79, Issue 4 , pp 501-509
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Risk factors
- Retinopathy of prematurity
- Industry Sectors
- Author Affiliations
- 1. Department of Pediatrics, Government Medical College, Chandigarh, India
- 3. Division of Neonatology & WHO Collaborating Centre for Training & Research in Newborn Care, Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
- 4. Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
- 2. Department of Ophthalmology, Dr. R. P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India