References

Bonthala S, Sparks JW, Musgrove KH, Berseth CL Mydriatics slow gastric emptying in preterm infants. J Pediatr. 2000; 137:(3)327-30

Brennan R, Gnanaraj L, Cottrell DG Retinopathy of prematurity in practice. I: screening for threshold disease. Eye. 2003; 17:(2)183-8

Castillo A, Deulofeut R, Critz A, Sola A Prevention of retinopathy of prematurity in preterm infants through changes in clinical practice and SpO2technology. Acta Paediatr. 2011; 100:(2)188-92 https://doi.org/10.1111/j.1651-2227.2010.02001.x

Chen ML, Guo L, Smith LE, Dammann CE, Dammann O High or low oxygen saturation and severe retinopathy of prematurity: a meta-analysis. Pediatrics. 2010; 125:(6)1483-92 https://doi.org/10.1542/peds.2009-2218

An international classification of retinopathy of prematurity. The Committee for the Classification of Retinopathy of Prematurity. Arch Ophthalmol. 1984; 102:(8)1130-4

Dempsey E, McCreery K Local anaesthetic eye drops for prevention of pain in preterm infants undergoing screening for retinopathy of prematurity. Cochrane Database Syst Rev. 2011; (9) https://doi.org/10.1002/14651858.CD007645.pub2

Dilen B, Elseviers M Oral glucose solution as pain relief in newborns: results of a clinical trial. Birth. 2010; 37:(2)98-105 https://doi.org/10.1111/j.1523-536X.2010.00389.x

Eckert GU, Fortes Filho JB, Maia M, Procianoy RS A predictive score for retinopathy of prematurity in very low birth weight preterm infants. Eye. 2012; 26:(3)400-6

Fleck BW, McIntosh N Pathogenesis of retinopathy of prematurity and possible preventive strategies. Early Hum Dev. 2008; 84:(2)83-8

Fortes Filho JB, Costa MC, Eckert GU, Santos PG, Silveira RC, Procianoy RS Maternal preeclampsia protects preterm infants against severe retinopathy of prematurity. J Pediatr. 2011; 158:(3)372-6

Good WV, Hardy RJ, Dobson V Final visual acuity results in the early treatment for retinopathy of prematurity study. Arch Ophthalmol. 2010; 128:(6)663-71

Hellström A, Engström E, Hård AL Postnatal serum insulin-like growth factor I deficiency is associated with retinopathy of prematurity and other complications of premature birth. Pediatrics. 2003; 112:(5)1016-20

Hered RW, Gyland EA The retinopathy of prematurity screening examination: ensuring a safe and efficient examination while minimizing infant discomfort. Neonatal Netw. 2010; 29:(3)143-51

Hylander MA, Strobino DM, Pezzullo JC, Dhanireddy R Association of human milk feedings with a reduction in retinopathy of prematurity among very low birthweight infants. J Perinatol. 2001; 21:(6)356-62

Kanski J, 7th edn. London: Butterworth Heinneman; 2011

Kao JS, Dawson JD, Murray JC Possible roles of bilirubin and breast milk in protection against retinopathy of prematurity. Acta Paediatr. 2011; 100:(3)347-51

Madden JE, Bobola DL A data-driven approach to retinopathy of prematurity prevention leads to dramatic change. Adv Neonatal Care. 2010; 10:(4)182-7

Mehta M, Adams GG, Bunce C, Xing W, Hill M Pilot study of the systemic effects of three different screening methods used for retinopathy of prematurity. Early Hum Dev. 2005; 81:(4)355-60

Mitchell AJ, Green A, Jeffs DA, Roberson PK Physiologic effects of retinopathy of prematurity screening examinations. Adv Neonatal Care. 2011; 11:(4)291-7

Neutze JA, Ferracotta CM Bevacizumab in the treatment of retinopathy of premturity. Review of Ophthalmology. 2013; 20:(4)

London: NMC; 2007

Olsson E, Eriksson M Oral glucose for pain relief during eye examinations for retinopathy of prematurity. J Clin Nurs. 2011; 20:(7-8)1054-9

London: RCPCH; 2008

Smith L Retinopathy of prematurity from a neonatal nursing perspective. International Journal of Ophthalmic Practice. 2011; 2:(6)252-9 https://doi.org/10.12968/ijop.2011.2.6.252

York JR, Landers S, Kirby RS, Arbogast PG, Penn JS Arterial oxygen fluctuation and retinopathy of prematurity in very-low-birth-weight infants. J Perinatol. 2004; 24:(2)82-7

Retinopathy of prematurity: Causes, prevention and treatment

02 September 2016
8 min read
Volume 24 · Issue 9

Abstract

Advances in neonatal intensive care have improved survival rates in extremely premature infants, which has led to an increase of retinopathy of prematurity (ROP) in the developed world. Left untreated, infants are at risk of developing strabismus, myopia, vitreous haemorrhage, vitreo-retinal fibrosis, retinal detachment, secondary angle closure glaucoma and, ultimately, complete loss of vision. The improvements in the understanding and treatment of ROP have been supported by seminal research, and its complexity is still being explored. However, the importance of early screening and treatment is essential in the prevention and management of this disease. This paper examines the causes and treatments of ROP, as well as implications for future neonatal practice.

Retinopathy of prematurity (ROP) is a proliferative disorder of the immature retinal vasculature. The retina has no blood vessels until around 16 weeks' gestation; the vessels grow out from the optic disc and only reach the periphery of the eye 1 month after birth (Kanski, 2011). ROP was recognised in 1942 in Boston, USA, by Theodore L Terry, and was initially named retrolental fibroplasia. It was described as a ‘fibroplastic overgrowth of persistent vascular sheath behind each crystalline lens’ (Fleck and McIntosh, 2008: 84). While Terry identified ‘fibroblastic overgrowth’, he did not identify the specific aetiological connection to oxygen. Further research, undertaken by Dr Patz in the 1950s in Washington DC, showed that premature infants now cared for in closed cots/incubators, who received high concentrations of oxygen in a confined space, were more likely to develop ROP than those who received low levels. This discovery resulted in oxygen levels administered to preterm infants being restricted to a maximum of 40%, which resulted in increased levels of morbidity and mortality. Thus, the importance of adequate oxygenation with careful monitoring of blood gas measurement and saturation monitoring was seen as the way forward in preventing ROP.

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