23-week premature infant, now at 31 weeks, presents for eye screen in the NICU
Pediatric Ophth/Strabismus, Retina/Vitreous
What is your diagnosis?
The diagnosis is...
The image is consistent with a diagnosis of retinopathy of prematurity (ROP):
- Retinopathy of prematurity is a disorder of abnormal retinal blood vessel growth that is seen in premature infants.
- Risk factors include low birth weight (less than 1500 g), young gestational age (less than 31 weeks' gestation), and high, unregulated oxygen supplementation at birth.
- Unfortunately, ROP is a progressive disease that can lead to retinal detachment and blindness in severe cases. However, many treatments are available to reduce the advancement of disease and mitigate complications.
What is the role of the neonatologist?
- Manage care for premature infants: avoid infant exposure to high, unregulated oxygen supplementation when possible, without increasing the risk of hypoxia.
- Refer infants for screening by a pediatric ophthalmologist based on current weight and gestational-age guidelines.
What is the role of the ophthalmologist?
- Complete screenings of premature infants, including regular follow-up examinations recommended by current society guidelines.
- Continue to follow the child throughout early development to screen for and manage amblyopia, strabismus, refractive error, and other eye diseases. Children previously diagnosed with ROP are at increased risk for developing additional ocular pathology.
What is the treatment?
Retinopathy of prematurity will resolve spontaneously in many cases with supportive care from the NICU.
Treatment is based on the degree and progression of abnormal retinal vascularization. Laser, cryotherapy, or eye injections may be used to reduce abnormal blood vessel formation.
Learn more: Ophthalmology resources for medical students