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Retinopathy of Prematurity

Retinopathy of Prematurity is a topic covered in the 5-Minute Clinical Consult.

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  • 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


  • 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.

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 or more.

Commonly Associated Conditions

Neonatal respiratory distress syndrome

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Stephens, Mark B., et al., editors. "Retinopathy of Prematurity." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2019. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116905/all/Retinopathy_of_Prematurity.
Retinopathy of Prematurity. In: Stephens MB, Golding J, Baldor RA, et al, eds. 5-Minute Clinical Consult. 27th ed. Wolters Kluwer; 2019. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116905/all/Retinopathy_of_Prematurity. Accessed April 24, 2019.
Retinopathy of Prematurity. (2019). In Stephens, M. B., Golding, J., Baldor, R. A., & Domino, F. J. (Eds.), 5-Minute Clinical Consult. Available from https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116905/all/Retinopathy_of_Prematurity
Retinopathy of Prematurity [Internet]. In: Stephens MB, Golding J, Baldor RA, Domino FJ, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2019. [cited 2019 April 24]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116905/all/Retinopathy_of_Prematurity.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Retinopathy of Prematurity ID - 116905 ED - Stephens,Mark B, ED - Golding,Jeremy, ED - Baldor,Robert A, ED - Domino,Frank J, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116905/all/Retinopathy_of_Prematurity PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -