Retinopathy of prematurity

Increasing numbers of immature infants are surviving with incompletely developed retinal vessels at risk for ROP. Since adverse perinatal events seem closely associated with the more severe forms of the disorder, neonatologists may be able to contribute most to the reduction of vision loss if they can optimize the neonatal course of these infants. However, to date, no particular intervention has been proven to be efficacious in preventing ROP. On the other hand, cryotherapy has been found effective in stopping the progress of severe ROP to retinal detachments about half the time. This places a responsibility on the neonatologist and ophthalmologist to assure that each at-risk infant is examined by 4-6 weeks of age to enable the prompt application of cryotherapy if severe ROP develops. This is presently the infant's best chance of retaining useful vision, and appropriate nursery policies should be developed to ensure its availability. Additional research is needed to understand the control of regression vs progression in ROP and to explore potential means of preventing the disease altogether.