INTRODUCTION(lucky)

 Retinopathy of prematurity is a disease of the developing retinal vasculature resulting from the
interruption of normal progression of the newly forming vessels.
 Approximately 60% of high risk babies develop ROP.
 It is a multifactorial disorder with incidence increasing with decreasing gestational age.
 It is one of the most common causes of blindness and other vision errors in children.

DEFINITIONS(lucky)

 Full term: child bornn between 39wks and 40 wks

 Pre-term baby: child born < 37 wks of pregnancy
 Gestational age(GA): Time elapsed between the first day of LMP and the day of delivery (in
weeks)
 Chronological age(CA): Time elapsed after birth
 Post menstrual age: GA + CA

RISK FACTORS(lucky)

 Extreme prematurity- Gestational age less than 32 wks

 Birth weight <1500g
 Exposure to supplemental oxygen
 Duration of mechanical ventilation
 Apnea
 Severity of illness(e.g sepsis, respiratory distress syndrome, bronchopulmonary dysplasia)
 Acidosis
 Blood transfusion
 Retinal light exposure

Overview(lucky)

Prematurity> incomplete retinal vasculature> hyperoxia> vasoconstriction > vaso-obliteration> hypoxia>

VEGF> Neovascularization> fibrovascular proliferation> +/- complications

Pathophysiology and clinical features (Qua’s part)

Complications

Complications of ROP include myopia, early development of cataracts, iris neovascularization, glaucoma,
retinal pigmentation, retinal folds, dragging of the retina, lattice-like degeneration, retinal tears, and
rhegmatogenous and exudative retinal detachments.
Differentials

1. Retinoblastoma

2. Cataract

3. Coat's disease

3. Persistent hyperplastic primary vitreous

4. Chronic vitreous hemorrhage

5. Familial exudative vitreoretinopathy

6. Endogenous endophthalmitis

7. Norrie's disease

8. Retinochoroidal coloboma

9. Incontinentia Pigmentia

Screening (lucky)

Should be performed in all infants:

1. Weight= <1500g, 30wks gestation

2. Weight >1500g, with an unstable clinical course
 Screening to be done should start at 4-6wks of age or 31-32 wks postmenstrual age.
Examination to be done every 2-3 weeks till maturity is reached, if no disease is found.

Infants with ROP to be examined every 1-2 wks until vessels are mature or disease threshold has passed
away.

Algorithm for screening;

Diagnosis and treatment (Egbukom)