CHAPTER 18 Retinopathy of prematurity (ROP)
• The strongest risk factors for ROP are gestation and birth weight. The majority of significant ROP occurs in babies born at less than 28 weeks gestation.
Babies at high risk for ROP are examined by an ophthalmologist to screen for the disorder.
• The most commonly used criteria for ROP screening are birth weight <1500 g or gestation at birth <32 weeks (as is done in our unit).
• Some units will include slightly bigger or mature babies if they have required significant oxygen supplementation or have otherwise been significantly unwell.
Management
ROP is described according to the retinal zone involved (Zones 1–3), the stage of disease (Stages 1–5), the extent of disease (in clock hours) and whether there is ‘plus’ disease present.
• In most babies the retina will vascularise progressively from posterior (Zone 1) to anterior (Zone 3) without the need for intervention.
• In a small number, usually those with Stage 3 or greater disease (although the decision will depend on factors such as how aggressive the disease is and will obviously rest with the ophthalmologist), the retinopathy will be treated in an attempt to arrest disease progression and preserve as much functional vision as possible.
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