Retinopathy of prematurity (ROP) or Terry syndrome, previously known as retrolental fibroplasia (RLF), is a disease of the eye affecting prematurely-born babies generally having received intensive neonatal care, in which oxygen therapy is used on them due to the premature development of their lungs. It is thought to be caused by disorganized growth of retinal blood vessels which may result in scarring and retinal detachment. ROP can be mild and may resolve spontaneously, but it may lead to blindness in serious cases.
HOW IS ROP DIAGNOSED?
In most cases, the first exam should be within 4 to 9 weeks after birth, depending on the baby's gestational age.
• Babies born at 27 weeks or later most often have their exam at 4 weeks of age.
• Those born earlier most often have exams later.
Follow-up exams are based on the results of the first exam. Babies do not need another exam if the blood vessels in both retinas have completed normal development. Depending on the amount of abnormal blood vessel development, the baby’s condition will be graded and further examinations will be conducted every one to two weeks, depending on a variety of factors. These factors include the severity and location in the eye of ROP, and the rate of progression of blood vessel formation, called vascularization. In the majority of cases, even when ROP develops, it will resolve spontaneously with minimal effect on vision. However, a small percentage of babies screened for ROP, approximately 10%, will progress to the extent that it is no longer safe to wait for spontaneous resolution. For these babies, treatment will be offered to reverse the progression of ROP.
HOW IS ROP TREATED?
Early treatment has been shown to improve a baby's chances for normal vision. Treatment should start within 72 hours of the eye exam. Some babies with ""plus disease"" need immediate treatment.
• Laser therapy (photocoagulation) may be used to prevent complications of advanced ROP.
• The laser stops the abnormal blood vessels from growing.
• The treatment can be done in the nursery using portable equipment. To work well, it must be done before the retina develops scarring or detaches from the rest of the eye.
• Other treatments, such as injecting an antibody that blocks VEGF (a blood vessel growth factor) into the eye, are still being studied.
DID YOU KNOW?
Retinopathy of prematurity (ROP) generally affects preterm infants born before week 31 of pregnancy and weighing 2.75 pounds (1,250 grams) or less at birth. In most cases, ROP resolves without treatment, causing no damage. Advanced ROP, however, can cause permanent vision problems or blindness.