Retinopathy of prematurity (ROP)

Overview

Abnormal vascular proliferation of the developing retina in PRETERM/low-birth-weight infants, driven by prematurity and oxygen exposure. Ranges from spontaneous regression to retinal detachment and blindness. Detected by SCREENING (eligible preterm infants are examined at set times); treated with laser/anti-VEGF for threshold disease. (Cross-references ophthalmology.)

Recognise

• Preterm/low-birth-weight infant (especially with significant oxygen exposure); asymptomatic — detected on SCREENING
• Staged by zone/extent; 'plus disease' (dilated tortuous vessels) signals activity
• Untreated severe disease → retinal detachment, blindness

Differentials & how to tell them apart

Investigations

ROP SCREENING (indirect ophthalmoscopy) in eligible preterm infants per the national protocol; staged and zoned.

Management

Screening → laser/anti-VEGF for threshold disease

1. 1Screen eligible preterm infants per protocol. Treat threshold/plus disease with laser or anti-VEGF to prevent progression.Gate: ROP is a SCREENING diagnosis (asymptomatic) — eligible preterm infants must be examined on schedule; careful oxygen targeting reduces incidence
2. 2Treat threshold disease; ongoing ophthalmology follow-up (refractive error, late detachment). (See ophthalmology for retinal detail.)

Monitor & prognosis

Serial screening; post-treatment follow-up.

Often regresses; severe disease threatens sight.