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Published on: May 9, 2023
[Childhood retinal detachment: ROP and myopia]
1Augenklinik der Charité Universitätsmedizin Berlin (Standorte Virchow Klinikum und Klinikum Benjamin Franklin).
Insights
Retinopathy of prematurity (ROP) can lead to tractional retinal detachment, with outcomes depending on early treatment. Lifelong monitoring is crucial for ROP residuals due to risks of further retinal detachment.
Area of Science:
- Ophthalmology
- Neonatal Medicine
- Retinal Vascular Diseases
Context:
- Retinopathy of prematurity (ROP) arises from incomplete retinal vascularization after premature birth.
- ROP progresses through phases involving hypoxia, vascular proliferation, and vitreoretinal traction.
- ROP residuals can manifest as tractional or rhegmatogenous retinal detachments later in life.
Purpose:
- To review the causes and treatment strategies for retinopathy of prematurity-related tractional retinal detachment.
- To discuss detachments in ROP residuals during childhood and early adulthood.
- To highlight the long-term implications and monitoring needs for ROP patients.
Summary:
- Phase I of ROP involves delayed vascular growth and hypoxia; Phase II features hypoxia-driven vascular proliferation causing traction.
- Treatment outcomes for tractional detachment in ROP vary, with re-attachment rates over 70% reported for ROP IV a, but limited functional and anatomic results in later stages.
- Myopia is associated with ROP, increasing the risk of rhegmatogenous detachment in ROP residuals, necessitating lifelong ophthalmological surveillance.
Impact:
- Understanding ROP progression and treatment effects is vital for managing long-term visual outcomes.
- Early and appropriate interventions can influence the success of treating ROP-related retinal detachments.
- Lifelong monitoring is essential for individuals with a history of ROP to detect and manage potential complications like rhegmatogenous detachment.
Abstract:
This article reviews the cause and treatment options for retinopathy of prematurity (ROP)-related tractional detachment and detachments in ROP residuals during childhood and early adulthood. Retinal vascularisation is incomplete after premature birth. Phase I of ROP consists of a delayed retinal vascular growth and vessel loss after premature birth resulting in hypoxia, phase II results in hypoxia-induced vascular proliferation and as a consequence to vitreoretinal traction. The anatomic and functional outcome of tractional detachment in ROP is determined by the previous treatment (e.g., laser to the avascular periphery or anti-VEGF). While the literature reports re-attachment rates > 70 % in ROP IV a, functional and anatomic outcome in the later stages is limited. ROP residuals may cause rhegmatogenous rather than tractional detachments in childhood or early adulthood. Myopia is associated with ROP and may further complicate the retinal situation and the risk for rhegmatogenous detachment. The retinal changes due to ROP warrant lifelong controls.
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