Retinopathy of prematurity is a disorder of retinal blood vessel development that occurs in premature infants, particularly those with very low birth weight or requiring oxygen therapy. Abnormal vessel growth can threaten the retina and impair vision.
Development and Staging
In early gestation, retinal vessels are incomplete and continue to grow after birth. In preterm infants, this process may be disrupted, leading to areas of non-perfusion, abnormal new vessels at the junction, and in severe cases retinal traction or detachment.
- Screening focuses on infants born very prematurely or with very low birth weight
- Severity is graded by stage, zone, and presence of plus disease
- Mild forms may regress spontaneously
- Advanced disease can cause permanent vision loss
Management
Regular retinal screening in at-risk infants allows timely treatment. Laser therapy or intravitreal anti-VEGF injections are commonly used when threshold disease is reached, and surgery may be needed for tractional detachments.
- Close collaboration between neonatology and ophthalmology teams is essential
- Follow-up continues into childhood to monitor visual development
- Children may have increased risk of refractive errors, strabismus, or amblyopia
- Careful oxygen management in neonatal units helps reduce risk
