Pathogenesis and Management of Retinopathy of Prematurity in Premature Infants

Vasantha HS. Kumar*

Pathogenesis and Management of Retinopathy of Prematurity in Premature Infants.

Retinopathy of Prematurity (ROP) continues to be a major cause of preventable blindness in considerable parts of the world, including developing countries. The incidence of ROP varies with the level of neonatal care; adequate screening and follow-up of these infants is essential for intervention to occur at the appropriate time. Even though the pathophysiology is not certain, oxygen and its interaction with angiogenic factors plays a central role in the development of the disease. Despite the role of oxygen in the pathogenesis of ROP, optimal oxygen saturation in the first few weeks of life in the premature infant remains unclear. Current treatment strategies include ablation of the peripheral avascular retina, management of abnormal vasoproliferation in late stages of disease and visual rehabilitation.

The incidence of premature births is increasing throughout the world, and with it, ROP is now appearing in countries with the technology to save premature infants. Consequently ROP has become a leading cause of childhood blindness worldwide.2 The management of ROP include screening of at-risk preterm infants by frequent retinal examinations followed by treatment interventions if necessary, such as laser treatment of the peripheral avascular retina in eyes with severe ROP and visual rehabilitation.

However, the switch from hyaloid to retinal vasculature begins at around 16 weeks of gestation with the development of the vascular plexus beginning at the optic nerve head and spreading centrifugally. As glial cells such as the astrocytes cover much of the retina during development, they may act as a template for endothelial cell migration to occur promoting vasculogenesis.

Pediatr Neonatal Nurs Open J. 2015; 2(2): 62-69. doi: 10.17140/PNNOJ-2-110