retinopathy of prematurity

Question 1

affects

Answer 1

preterm and low birth weight babies

typically affects babies born < 32wks

Question 2

what

Answer 2

abnormal development of blood vessels in retina leading to scarring, retinal detachment and blindness

Question 3

pathophysiology

Answer 3

retinal vessel development starts 16wks and complete 37-40wks

vessel formation stimulated by hypoxia - normal in pregnancy

when higher oxygen in premature babies, stimulant for development is removed

when hypoxia recurs, retina produces excessive blood vessels (which can then regress) and sca tissue

Question 4

plus disease

Answer 4

additional findings such as tortuous vessels + hazy virteous humour

Question 5

who should be screened

Answer 5

babies born < 32wks or under 1.5kg

Question 6

when does screening start

Answer 6

30-31wks gestational age in babies born < 27wks

4-5wks of age in babies born >27wks

Question 7

when should screening happen

Answer 7

at least every 2wks

can stop once retinal vessels enter zone 2 (usually ~36wks gestation)

Question 8

what does screening involve

Answer 8

monitoring retinal vessels as they develop

looking for plus disease

Question 9

treatment

Answer 9

1. transpupillary laser photocoagulation

cryotherapy
intravitreal VEGF inhibitor injection s
surgery if retinal detachment