Dr Rakesh Seenappa, Regional Head – Retina Services, Dr Agarwals Eye Hospital, Rajajinagar, Bangalore highlights that while approximately 80 per cent of ROP cases resolve on their own, the remaining 20 per cent require medical intervention. It is essential that every preterm baby undergo an eye examination by a ROP-trained ophthalmologist to ensure timely treatment
Retinopathy of Prematurity (ROP) is a serious condition that affects premature or low birth weight (LBW) infants. Babies born with a gestational age of less than 34 weeks, as well as those between 34 to 36 weeks with additional risk factors or weighing 1.5 kg or less, are particularly vulnerable to Retinopathy of Prematurity (ROP). While approximately 80 per cent of ROP cases resolve on their own, the remaining 20 per cent require medical intervention. It is essential that every preterm baby undergo an eye examination by a ROP-trained ophthalmologist to ensure timely treatment.
Studies show that the incidence of ROP among premature or low birth weight (LBW) infants ranges from 30 per cent to 50 per cent, underscoring the magnitude of the problem. Without early diagnosis and treatment within the first few weeks of life, around 30 per cent of NICU infants may develop ROP, with nearly 10 per cent at risk of complete blindness if they do not see an eye specialist within 30 days of birth. Prompt treatment, often with laser therapy, should be initiated within 2 to 3 days of diagnosis to prevent severe complications.
Risk factors
Several factors increase the likelihood of developing ROP:
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Birth before 34 weeks of gestation
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Birth weight under 1,600 grams
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Prolonged oxygen therapy
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Respiratory distress
Treatment options
There are various treatment options for managing ROP:
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Retinal Laser Therapy: A non-surgical treatment that can be done in the NICU.
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Anti-VEGF (Anti-Vascular Endothelial Growth Factor) Injections: These injections are performed in a sterile environment, usually in an operating room.
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Surgical interventions: These may include vitrectomy (removing the vitreous gel from the eye) or scleral buckling (supporting the eyeball). Despite early treatment, some children may still face vision problems, lazy eye, or significant vision errors. However, without treatment, the risk of blindness increases dramatically.
Screening guidelines
To prevent blindness from ROP, the Ministry of Health and Family Welfare in India has set guidelines under the Rashtriya Bal Swasthya Karyakram:
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Who to screen: Infants with a birth weight under 2,000 grams, gestational age less than 34 weeks, or those with other risk factors.
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When to screen: The first screening should take place four weeks after delivery. For infants born before 28 weeks or weighing less than 1,200 grams, screening should occur within 2-3 weeks after delivery.
Unfortunately, many infants remain undiagnosed until it is too late, leading to irreversible damage. Raising awareness among the general public and healthcare providers is essential.