Which Premature Infants Need Eye Exams?

Discussion Retinopathy of prematurity (ROP) is a developmental problem. Term infants have full vascularization of the retina and therefore cannot have ROP. Premature infants however do not have full vascularization (which proceeds from the periphery to the central retinal area) and therefore may have abnormal and excessive vascularization. It affects premature infants primarily < 31 weeks gestation. Although the mechanism of ROP is not completely understood, increased oxygen levels are a risk factor. Additionally there is data which shows growth factors such as vascular endothelial growth factor (VEGF) are increase,d resulting in abnormal vascularization. Prevention is the best treatment for ROP which includes lower oxygen saturation targets (current targets are in the low 90s%) and proper parenteral nutrition. With cryo- and laser therapy, the outcomes for premature infants with lower rates of any ROP and especially severe ROP have dramatically improved. ROP treatment depends on the location and extent of the disease, and type of disease. Location closer to the macula, more retinal area involved and “plus” disease (i.e. which has abnormal dilation and tortuosity of the retinal blood vessels) all have worse prognoses. Ablative treatment with laser or cryotherapy or use of anti-VEGF medications (anti-vascular endothelial growth factor) are the usual treatments. Learning Point According to the American Academy of Pediatrics (AAP) the following infants should be s...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news