Retinopathy of prematurity (ROP) is a proliferative retinopathy that affects premature infants, especially those with very low birth weights who received supplemental oxygen. The incompletely developed retinal blood vessels of premature infants are susceptible to abnormal growth in response to high oxygen levels. ROP progresses through five stages, from early vascular changes to total retinal detachment. Staging is based on the zone of the retina involved and extent of abnormal blood vessel proliferation. Timely eye exams by an ophthalmologist starting at 4 weeks of age can detect ROP for potential laser or cryotherapy treatment to prevent vision loss.

1. Retinopathy
Of Prematurity
Presented by
Khulesh Sahu
B.Optometry 5th Sem.
Guided by
Shravani Reddy

2. Defination of ROP
The term ‘Retinopathy Of Prematurity was first
suggested by Heath in 1952
ROP is a proliferative retinopathy affecting
pre term infants of low birth weight who
have often been exposed to high ambient
oxygen concentrations

3. Causes of ROP
• Prematurity: It affects prematurely born
babies.
• All babies less than 1500 g birth weight .
• supplement oxygen therapy

4. Pathogenesis
• Normal eye ( full-term pregnancy is about
38–42 weeks ).
A. Normal retina is gradually vascularized from
optic disc to peripheri
B. The nasal retina vessels reaches ora serrata
after 8th month.
C. The temporal retinal vessels reaches ora
serrata after 1 month of delivery by the effect
of VEGF.

5. • Premature birth eye ( Pre-term pregnency
31 week )
A. Incomplete retinal vascularisation.
B. The peripheral vascular retina becomes
hypoxia
C. Releas VEGF, which stimulate blood vessel
growth
D. The production of VEGF is downregulated
and vessel migration is halted.

6. Stages of ROP
Classification of ROP
•ICROP is based on the stage, zone and extent
of diseas.
Stage1 :- Demarcation Line
•A line that is seen at the edge of vessels, dividing the
vascular from the avascular retina.

7. Vascular retina

8. • Stage 2 Ridge
The line structure of stage 1 acquires a volume to form a
ridge with height and width.
•

9. Stege 3Ridge with extra-retinal fibrovascular
proliferation
This stage is further subdivided into mild, moderate and
severe, depending on the amount of fibrovascular
proliferation

10. Stage 4 sutotale retinal detachment
macula is not involve macula os involve

11. Stage 5 :- Total retinal detachment

12. Zone of ROP
• Zone 1
• The radius is twice the distance from the disc to the
macula
• Zone 1 is more severe compared with disease limited to
zones 2 or 3
• Zone 2
• Extends to the nasal ora serrata and slightly anterior to
the equator temporally.
• It is the intermediate zone where blood vessels often
stop in ROP

13. •Zone 3
• It is the peripheral zone of the retina, where vessels are
absent in ROP, but present in normal eyes.

14. ROP:Diagnosis
•The only way to diagnose that baby has ROP
is an eye exam by an ophthalmologist at 4
weeks of age.

15. Treatment
• Laser treatment
1. Laser photocoagulation
2. Cryotherapy
• Post laser treatment and follow up
1. Antibiotic and steroid eye drops
2. Long term follow up
• Surgical treatment
1. Vitrectomy ( in 4 and 5 stage of ROP )

16. Referance
• Comprehensive Ophthalmology- By
A.K.Khurana.
• Clinical Ophthalmology- By Jack J. Kanski.
• www.google.com