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Natural history of retinopathy of prematurity
W E Schulenburg1, A Prendiville, R Ohri
1Department of Surgery, Hammersmith Hospital, London.
Insights
Retinopathy of prematurity (ROP) affects at-risk infants, with rapid progression to severe stages possible. Understanding ROP
Area of Science:
- Ophthalmology
- Neonatology
- Perinatal Medicine
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- The incidence and natural history of ROP require further investigation to optimize management strategies.
Purpose of the Study:
- To assess the incidence and natural history of retinopathy of prematurity (ROP) in at-risk infants.
- To characterize the progression patterns and identify prognostic indicators of ROP.
Main Methods:
- Prospective study involving 69 infants at risk for ROP.
- Systematic observation and staging of ROP development and progression.
Main Results:
- Seventeen infants (24.6%) developed ROP, with 6 eyes progressing to stage IV.
- Rapid progression from stage I to III was observed, influenced by the affected zone.
- Congestion and tortuosity of posterior pole vessels indicated stage III ROP.
- Progression to stage IV was slower, marked by vitreoretinopathy and vitreous haze.
- Iris congestion and poor mydriasis were grave signs of impending retinal detachment.
Conclusions:
- ROP is characterized by a self-limiting nature, but the stage of inactivity varies, impacting outcomes.
- Early identification of disease progression and associated signs is crucial for timely intervention.
- Understanding the natural history of ROP aids in predicting visual prognosis.
Abstract:
Sixty-nine infants at risk of developing retinopathy of prematurity (ROP) were entered into a prospective study to assess the incidence and natural history of the disease. Seventeen infants developed ROP, and in six eyes the disease progressed to stage IV ROP. The natural regression of a pupillary membrane and physiological vitreous haze was not influenced by the onset of ROP. Progression from stage I to stage III was rapid and the rate was influenced by the zone affected. Congestion and tortuosity of vessels in the posterior pole always signified stage III ROP. Progression from stage III to stage IV ROP was slower; it was characterised by the development of vitreoretinopathy, signified by the sudden onset of a vitreous haze. Iris congestion associated with poor mydriasis may be a grave sign indicating imminent retinal detachment. Cicatricial ROP can be divided into retinal and vitreoretinal cicatricial disease directly related to the stage of active disease reached. ROP is characterised by its self limiting nature, but the stage at which it becomes inactive varies and will influence the final outcome.