Retinopathy of prematurity (ROP) is a vascular disease of the retina that is limited to premature babies. The clinical severity can vary from mild cases with no regression to severe cases with retinal detachment. However, thanks to today's early detection examinations and treatment options, blindness can usually be prevented.
Cause of retinopathy of prematurity
The development of the retinal vessels normally begins from the 16th week of pregnancy and continues until the birth date. The early birth changes the oxygen conditions in the maturing retina, which can lead to an uncontrolled proliferation of pathological vessels. These vessels can spill over into the vitreous body, causing the retina to become increasingly detached. This results in visual impairment due to scarring, short-sightedness or even blindness.
Very immature premature babies are particularly at risk, e.g.
- those born before the 31st week of pregnancy,
- born with a birth weight of less than 1500g
- with additional oxygen treatment
- with additional other diseases
Prevention
All premature babies who are at risk of ROP due to their gestational age are included in the ROP screening programme. In line with the guidelines, the fundus of the eye is examined at regular intervals. This strict ophthalmological monitoring enables immediate countermeasures to be taken if there is a risk of retinal detachment.
Therapy
If the disease is at a stage that requires treatment, the prognosis can be improved with laser treatment. Scabbing of the outer retina leads to stabilisation and regression of the vascular growths. Alternatively, a medication is available that can regress the pathological vessels when administered intravitreally. In more advanced stages, retinal surgery must be considered after careful assessment of the individual case.
Aftercare
Anatomical and functional eye disorders (spectacle correction, strabismus, retinal changes) occur more frequently in premature babies than in children born at term. Therefore, premature babies should have regular ophthalmological check-ups in the first few years of life.
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