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Retinopathy of prematurity (ROP)
Pediatric Ophthalmology
Key Points
- •ROP is a vasoproliferative disorder of the immature retina - two phases: hyperoxia (Phase 1, vessel obliteration) and hypoxia (Phase 2, pathological neovascularisation driven by VEGF)
- •Screening criteria: BW ≤1500 g or GA ≤30 weeks; first exam at 31 weeks PMA or 4 weeks chronological age (whichever is later)
- •Type 1 ROP is the treatment threshold per ET-ROP trial - treat within 48–72 hours; Type 2 ROP is observed closely
- •Anti-VEGF (bevacizumab) is superior to laser for Zone I ROP (BEAT-ROP: 4% vs 22% recurrence) and preserves peripheral retinal vascularisation
- •Stage 5 total retinal detachment carries very poor prognosis - anatomic reattachment in =<30–40%==; prevention through timely screening and treatment is paramount
- •Late recurrence after anti-VEGF (up to 16–20 weeks) requires prolonged post-treatment follow-up - critical difference from laser (which is definitive)
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Keep reading Retinopathy of prematurity (ROP)
17 more sections are included with the Clinical plan.
- Definition
- Epidemiology
- Aetiology and causes
- Pathogenesis
- Classification
- Risk factors and associations