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Retinopathy of prematurity - Symptom

Alternative Names

Retrolental fibroplasia; ROP

Symptoms:

There are 5 stages of ROP.

Stage I: There is mildly abnormal blood vessel growth.
Stage II: Blood vessel growth is moderately abnormal.
Stage III: Blood vessel growth is severely abnormal.
Stage IV: Blood vessel growth is severely abnormal and there is a partially detached retina.
Stage V: There is a total retinal detachment.

The blood vessel changes cannot be seen with the naked eye. An eye exam is needed to reveal such problems.

An infant with ROP may be classified as having “plus disease” if the dilation and twisting of the blood vessels matches or exceeds a standard photograph.

Symptoms of severe ROP include:

Abnormal eye movements
Crossed eyes
Severe nearsightedness
White-looking pupils (leukocoria)

Signs and tests:

High-risk infants and those younger than 30 weeks gestation or born weighing fewer than 3 lbs should have retinal exams.

The first exam usually should be 4 - 9 weeks after birth, depending on the baby� ' s gestational age. Babies born at 27 weeks or later usually have their exam at 4 weeks of age. Those born earlier usually have exams later.

Follow-up examinations are determined based on the results of the first exam. Babies do not need another examination if the blood vessels in both retinas have completed normal development.

Parents should know what follow-up eye exams are needed before the baby leaves the nursery.

Reviewed last on: 4/13/2009
Paul B. Griggs, MD, Department of Ophthalmology, Virginia Mason Medical Center, Seattle, WA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Section on Ophthalmology American Academy of Pediatrics, American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus. Screening examination of premature infants for retinopathy of prematurity. Pediatrics. 2006 Feb;117(2):572-6.

Early Treatment For Retinopathy Of Prematurity Cooperative Group. Revised indications for the treatment of retinopathy of prematurity: results of the early treatment for retinopathy of prematurity randomized trial. Arch Ophthalmol. 2003 Dec;121(12):1684-94.

International Committee for the Classification of Retinopathy of Prematurity. The International Classification of Retinopathy of Prematurity revisited. Arch Ophthalmol. 2005 Jul;123(7):991-9.

Tasman W. Retinopathy of Prematurity: the life of a lifetime disease. Am J Ophthalmol. Jan 2006; 141(1): 167-74.

Yanoff M, Duker JS, Augsburger JJ, et al. Ophthalmology. 2nd ed. St. Louis, Mo: Mosby; 2004.

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