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Retinopathy of prematurity - Treatment

Alternative Names

Retrolental fibroplasia; ROP

Treatment:

Early treatment has been shown to improve a baby� ' s chances for normal vision. Treatment should start within 72 hours of the eye exam.

Some babies with “plus disease” need immediate treatment.

Treatment may include cryotherapy (freezing) to prevent the spread of abnormal blood vessels.

Laser therapy (photocoagulation) may be used to prevent complications of advanced ROP. The laser therapy stops the abnormal blood vessels from growing. It can be performed in the nursery using portable equipment. To be effective, it must be done before scarring and detachment occurs

Surgery is needed if the retina detaches. Surgical procedures continue to improve, but may not result in good vision.

Expectations (prognosis):

Most premature infants with ROP recover with no lasting visual problems. Many premature infants with slight problems in retinal blood vessel growth have the vessels return to normal without treatment. Most infants with mild ROP can be expected to recover completely.

About 1 out of 10 infants with early changes will develop more severe retinal disease. Severe ROP may lead to significant vision problems or blindness. The most important factor in the outcome is early detection and treatment.

Complications:

Complications may include severe nearsightedness and blindness.

Most infants with severe vision loss related to ROP have other complications of prematurity and require a multidisciplinary approach to rehabilitation.

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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