Retinopathy of Prematurity

Description

• Proliferative disorder of the retinal blood vessels in premature infants: The normal retinal vascularization occurs nasally at ~36 weeks’ gestational age and temporally at ~40 weeks’ gestational age.
• System(s) affected: nervous
• Synonym(s): ROP; retrolental fibroplasia

Epidemiology

Incidence

• 65.8% of infants weighing <1,251 g at birth and 81.6% of those weighing <1,000 g
• Predominant age: premature infants
• Predominant sex: male = female

Etiology and Pathophysiology

Oxidative processes (influenced by high levels of arterial oxygen) in immature retina may be an important causative factor.

Genetics
African American infants appear less susceptible.

Risk Factors

• Low birth weight
• Poor postnatal weight gain
• Prematurity
• Supplemental oxygen; once the retina becomes fully vascularized, oxygen does not affect the retina.
• Supplemental oxygen given to premature infants with moderate ROP will not make the retinopathy worse.
• Maternal diabetes is associated with the development of ROP in premature infants with a birth weight of ≥1,500 g.

Commonly Associated Conditions

Neonatal respiratory distress syndrome