What is Retinopathy of the Eye?
Retinopathy is a term that describes damage to the retina, the structure at the back of the eye that senses light and transfers data to the brain to interpret what we are seeing. Usually, retinopathy is associated with diabetes; a secondary health problem stemming from unregulated blood sugar. Retina damage may also occur simultaneously to premature birth. This is referred to as retinopathy of prematurity.
What is Retinopathy of Prematurity (ROP)?
Retinopathy of prematurity, ROP, is the leading cause of blindness in children in the US. Fortunately, ROP requiring treatment only occurs in a small percentage of premature infants. To identify infants who are at risk for visual loss, retinal screening exams are performed in infants weighing <1500 grams (3 1/3 pounds) and less than 31 weeks gestational age.
Because ROP can lead to permanent vision loss, doctors are conscientious about treating the damaged retina when high risk characteristics develop.
The ophthalmologists at VitreoRetinal Surgery, PA have obtained specific, high-level training to treat retinopathy of prematurity. In our practice, the treatment of ROP is performed by a Pediatric Vitreoretinal Surgeon, Dr. Quiram. Our practice is a well-known premier provider for this condition, and has the ability to provide clinical care in the office setting, as well as in local children’s hospitals.
ROP screening is routine practice for all premature infants who are born before 31 weeks and who weigh less than 1500 grams. Initial examination may occur between four and six weeks of age. Screening takes place with dilation, which widens the pupils to allow the best possible observation of internal ocular structures. Looking through the pupil to the back of the eye, the ophthalmologist can observe blood vessel development, and determine the presence of ROP.
Subsequent screening may be scheduled every week or two, determined by several factors and the initial grade of ROP. The grading of this condition is discussed at the initial screening. If the examination indicates that ROP may not resolve spontaneously or shows high risk characteristics that may progress to visual loss, treatment options will be reviewed.
What Causes Retinopathy Prematurity?
ROP develops subsequent to the growth of abnormal blood vessels on the retina. These fragile vessels may leak, causing scar tissue to form around the retina. This tissue may pull the retina from its intended position. Ultimately, this pull could cause the retina to detach. Retinal detachment is the primary factor in blindness caused by ROP.
Blood vessels begin to form in the eye approximately 16-weeks into pregnancy. Growth begins at the back of the eye, with the optic nerve, and then extends gradually outward to the edges of the retina. These vessels nourish and oxygenate retinal tissue. The development of the eye accelerates during the last 12 weeks of pregnancy. A full-term pregnancy allows for the completion of this development, though the retina continues to grow for another few weeks after birth. Premature birth shortens the developmental period of the retina, and also impedes optimal oxygenation and nourishment of this tissue.
Retinopathy of Prematurity Treatment
Our physicians have a unique educational background in the treatment of ROP. Several options exist, and those that are most appropriate are discussed if ROP becomes severe and requires treatment. These include:
Laser therapy which targets the abnormal blood vessels in the periphery of the retina.
Intravitreal Anti-VEGF injection which specifically targets the abnormal blood vessels of ROP
Vitrectomy surgery may be performed to repair retinal detachments and remove scar tissue.
ROP treatment is recommended appropriate to the degree of retinopathy that exists. In our Minnesota offices, patients can expect the full extent of information regarding their child’s case. We are pleased to serve families from Minneapolis, St. Paul, Blaine, Edina, Oakdale, Plymouth, St. Cloud, Duluth, and all surrounding areas.