retinopathy of prematurity (ROP) is a vision disorder that affects only premature babies, usually born before 32 weeks of gestation.
Vision loss occurs because the blood vessels in the eye are not fully developed until the third trimester. When a baby is born prematurely, the blood vessels continue to grow but are abnormal. The abnormal growth creates scar tissue and tension in the eye that pulls the retina away from the back of the eye, creating a retinal detachment.
This article discusses treatment options for retinopathy of prematurity, including surgery.
Treatment for ROP depends on the severity of the disease and the area of the eye affected. The only treatment for ROP is surgery. There are no over-the-counter (OTC) or prescription drugs to treat ROP.
The disease has five distinct stages, with stage 1 being the mildest and stage 5 the most severe.
Babies with stage 1 or 2 ROP may not need further treatment because sometimes the tissue will heal on its own and not cause other problems.
However, all premature infants must have regular eye exams to determine the need for treatment, even if the infant was initially diagnosed with mild stage 1 disease. Clinicians generally recommend treatment for ROP stage 3 and beyond.
Stage 5 ROP
Babies with ROP stage 5 have complete retinal detachment and can develop severe vision problems or blindness.
Surgery and Procedures
To treat ROP in babies with severe abnormal blood vessel growths outside the eye, surgery is required to destroy the abnormal blood vessels. An ophthalmologist may recommend surgery for infants with ROP of any severity, especially those in stages 3, 4, or 5.
Laser therapy is the most common treatment for ROP. It is more effective and has better long-term outcomes than the previously used cryotherapy (using freezing or near-freezing temperatures), which has largely been replaced.
Laser therapy involves burning off abnormal blood vessels that grow around the edge of the eye. Treatment destroys peripheral (lateral) vision, but it preserves the most important part of vision, central vision. This means that children will see directly what is happening in front of them, but they may not notice objects in their peripheral vision.
Injectable medication (Avastin or Lucentis)
Another newer treatment option includes injectable drugs, Avastin (bevacizumab) or lucentis (ranibizumab) enters the eye to stop abnormal blood vessel growth by inhibiting cell signaling.Since the procedure consists of injections, no further surgical treatment is required, many ophthalmologist (ophthalmologists) prefer it as an initial treatment.
Injectable drugs stop a process called vascular endothelial growth factor (vascular endothelial growth factor). Without this signal, blood vessels cannot grow.
Ophthalmologists can use these drugs alone or in combination with laser treatment. They are as effective as laser therapy and may even reduce disease recurrence better than laser therapy.
While research is ongoing, there is concern that the drugs may cause delayed blood vessel development in other parts of the body. Further research is underway to evaluate the long-term side effects of these injections.
Early Procedures for ROP
Even with surgery for ROP, the disease continues to worsen and children may develop retinal detachment. Children who already have severe ROP associated with partial retinal detachment or who develop retinal detachment after initial treatment may opt for more invasive surgery to try to save their vision.
A sort of sclera Buckling is only done in children with severe ROP.
The procedure involves placing a tight band around the eye to prevent the gel inside the eye (vitreous gel) from pulling on scar tissue that has formed due to abnormal growth of blood vessels. If the vitreous does not pull on the scar tissue, the retina can adhere to the wall.
It is important to note that the scleral buckle will eventually need to be removed to allow the eye to grow as the child grows.
A sort of Vitrectomy is an invasive procedure that involves removing the vitreous gel from inside the eye and replacing it with sterile saline solution. Surgeons also remove scar tissue that forms around abnormal blood vessels.
Vitrectomy allows the retina to lie down against the eye without being stripped away by scar tissue. However, this process is only successful about 30% of the time.
over-the-counter preventive therapy
arachidonic acid and Docosahexaenoic acid Acids are omega-3 fatty acids that are critical for eye and brain development. These nutrients are transferred from the pregnant person to the developing fetus later in pregnancy.
Babies born prematurely lack these essential nutrients. Researchers have recently determined that supplementing infant formula with these fatty acids reduces the risk of severe ROP.
Breastfeeding and ROP
Recent studies have shown that breastfeeding is a protective measure against ROP in premature infants and limiting disease progression in people who already have ROP.
Causes and risk factors of retinopathy of prematurity
Retinopathy of prematurity is a vision disorder in premature infants that can only be treated surgically. Sometimes, mild ROP does not require further treatment. Still, it’s important to discuss treatment options with your pediatrician and ophthalmologist.
If your baby was born prematurely, discuss regular eye exams with your pediatrician and eye specialist. Retinopathy of prematurity is treatable. Recommended preventive strategies and regular follow-up with an ophthalmologist will determine current and future needs.