Retinopathy of Prematurity (ROP)

RETINOPATHY OF PREMATURITY - ROP

Evidence

Late ROP Reactivation and Retinal Detachment in a Teenager

https://pubmed.ncbi.nlm.nih.gov/30114308/

Exudative and tractional retinal detachments have been reported as late sequelae of retinopathy of prematurity (ROP). The authors report a case of unilateral retinal detachment in a 19-year-old patient with history of peripheral ablation for ROP in the contralateral eye. This late reactivation is likely due to persistent avascular retina producing constant low levels of vascular endothelial growth factor. Therefore, close follow-up and ablation of peripheral avascular retina should be considered in patients with ROP, regardless of treatment history, to decrease lifelong risk of severe complications, including retinal detachment decades later. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:625-628.].

https://www.healio.com/ophthalmology/journals/osli/2018-8-49-8/%7B0ed98c9d-d4a0-4264-a091-2f8d986aeaf9%7D/late-rop-reactivation-and-retinal-detachment-in-a-teenager

Education

If a baby is born too early, their retinal blood vessels do not develop completely which can cause problems and can lead to Retinopathy of Prematurity. Abnormal blood vessels may grow out of the retina and leak, causing scar tissue to form, leading to detachment of the retina. This damage is known as retinal detachment and if not monitored or not treated at the correct time, can cause vision loss.

Once a premature baby, and now an adult with a history of ROP is still recommended to  receive follow-up eye exams to check for eye changes. Although there is a very low risk for retinal detachment at this time, eye changes have been reported as late result of retinopathy of prematurity (ROP).  The current research is following two population of formerly premature babies who are now adults is made up of 2 groups based upon whether peripheral retinal surgery was performed or not preformed and watched.

How often are eye exams recommended for retinopathy of prematurity (ROP)?

Regular eye exams by a specialist as often as he/she recommends. If the doctor detects a problem early on, he/she can treat most of these conditions without any vision loss.

Some of the changes that can evolve are:

Myopia (near-sightedness)
Strabismus (misalignment of the eyes)
Glaucoma
Retinal detachment

Therefore, regular follow-up should be considered in patients with ROP, regardless of treatment history, to decrease lifelong risk of severe complications as an adult.

Empowerment

Information and being empowered to make better choices for your health care is also important for your parents and carers.  As an adult you may now be making some decisions about your own health. It is important to find the right person to do your eye exams in a relaxed fashion who can give you clear information and clear follow-up guidelines and referrals to other healthcare providers. If you feel that you need further investigation the health care provider should be listening to your concerns. Writing out questions ahead of time is helpful if you have noticed problems in your vision. Most of all you should feel that your history of your premature birth should be taken seriously and they should help you feel comfortable during this time.

Questions for the health care provider

Could the ROP return?  
Extremely unlikely in adulthood.

Is it only the retinal detachment that could return?
Retinal detachment is an ongoing risk as the peripheral retina is weak and sometimes a vascular which increases the life long risk of retinal detachment.

Can vision improve or does vision stabilize and remain the same?
The first few years of life will determine the level of vision that will be obtained for life. Besides refractive errors and amblyopia, there’s substantial evidence that the micro structure of the macula could be altered in prematurity and that would have a permanent reduced vison in the eye.

Are there natural things like vitamins that can help eye health?
No evidence in this group of patients.

Useful Links:

http://brailleaustralia.org/2020/

https://www.visionaustralia.org/

“I didn’t realize that I needed to take my son to the eye doctor for check-ups regularly even in his adult years until I spoke to another parent whose daughter had ROP.  Being aware of life long risks from prematurity can help my child and I stay vigilant with health checks.”

Mum of 18 year old born at 28 weeks

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