What are the causes of ROP and how can it be treated?
The birth of a child is supposed to be a joyous event for parents. But for the parents of the thousands of premature, underweight infants born each year, their time of bliss quickly becomes a time of uncertainty and worry.
Children born weighing less than two and three-fourths pounds and before 31 weeks gestation are not only at risk of developing complications such as chronic lung disease, but they are also at risk of developing an ocular condition called Retinopathy of Prematurity (ROP). In fact, over half of these babies will be born with some version of ROP.
This disease was first diagnosed in 1942 and remains one of the most common causes of vision loss in childhood, according to the National Eye Institute (NEI).
What is Retinopathy of Prematurity?
“ROP is defined as abnormal blood vessel growth in the back of the eye,” said Kara Tison, OD, senior clinical instructor of University of the Incarnate Word’s Rosenberg School of Optometry. “It is caused by stress of the immature blood vessels in the back of the eye. Vessel growth is still occurring after birth and being born prematurely can disrupt this growth.”
Of the 28,000 premature infants born each year, more than 15,000 of these babies are born with some form of ROP, according to the NEI.
What causes ROP?
During the last few weeks of a mother’s pregnancy, the baby’s eyes are growing at a rapid rate. If the child is born prematurely, blood vessels can develop abnormally. These abnormal blood vessels can leak and create scar tissue that pulls on the retina. If the retina becomes detached, vision loss can occur.
Other factors can also cause these abnormal blood vessels to form, including poor overall health of the child, respiratory distress and anemia, according to the NEI.
“But having a low birth weight and being born premature are the main factors,” Tison said.
What complications are associated with ROP?
While many cases of ROP regress on their own, there are thousands of children who will feel the effects of this debilitating condition for years to come.
“Those with later stages of ROP can develop amblyopia, strabismus, nystagmus, or glaucoma,” Tison said. “They are also at an increased risk for retinal detachment, which could result in blindness.”
How is it detected?
At this time, doctors cannot detect ROP or predict which infants will develop this condition before the birth of the child. But if the condition is diagnosed quickly, treatment can help stop its progression. That’s why Tison encourages parents to be advocates for their children about the care they receive.
“Infants born at less than 1500 grams should be screened five to six weeks after birth and then every one to two weeks until normal vessel growth has occurred,” she said.
What are the stages of ROP?
Every case of ROP is characterized by five stages which range from Stage I which is characterized by mildly abnormal vessel growth that will most likely improve on its own to Stage V where the child’s retina has completely detached causing severe visual impairment, the NEI states.
How is ROP treated?
“Depending on the classification of the ROP, sometimes treatment isn’t necessary,” Tison said. “But, if treatment is needed, then there are several options for patients.”
Some of those treatments include:
Cryotherapy – During this procedure, the doctor uses a tool that generates freezing temperatures to freeze spots on the surface of the eye that overlap the periphery of the retina.
Laser Photocoagulation – Instead of freezing away abnormal vessels on the surface of the eye, a laser photocoagulation procedure essentially burns away the periphery of the retina that has no normal vessels.
Avastin® Injections – These injections, which contain bevacizumab, are known in the medical world as an anti-cancer drug. But now these injections are being used to stop bleeding from abnormal blood vessels in the eyes of premature infants to help save some of their eye sight.
The good news is that sometimes ROP regresses on its own and the child’s vision is never affected. And because of advances in technology and quality of care for premature infants, the rate of ROP has declined significantly in the last 50 years.
For more information about ROP and other conditions related to your child’s vision, visit the NEI’s website at www.nei.nih.gov.
Jessa McClure is a freelance writer, blogger, wife and mother of two.