12. Retinopathy of Prematurity

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Author:
sookylala
ID:
235343
Filename:
12. Retinopathy of Prematurity
Updated:
2013-11-11 01:52:25
Tags:
Retinopathy Prematurity
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Description:
Retinopathy of Prematurity
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  1. What is ROP?
    retinal bv development in premature low birth infacnts
  2. What happens in retinal development in prematurity?
    • normal BV growth stops
    • in utero: avasc ret produces VEGF to stimulate migration of vessels to temporal periphery
    • premature: VEGF is downregulated by hyperoxia and vessel migration is halted
    • then reintroduced to hypo-xia-> excessive VEGF-> neovascular complications
  3. What are the key features of ROP?
    • avascular peripheral retina
    • demarcation line between vasc and avasc retina
  4. What are the stages of ROP?
    • 1: demarcation line
    • 2: ridge arises
    • 3: extra retinal fibrovascular proliferation
    • 4: partial retinal detachment
    • 5: retinal detachment
  5. Regression?
    80% of cases spontaneously
  6. Plus disease in ROP?
    • no dilation of pupil: engorgement of iris vasc
    • vitreous haze
    • dilation of veins tortuosity of arteries
    • preretinal/vietrous haemmorhage
    • abnormal vessel growth on iris
  7. DDX?
    • leukocoria: Rb
    • exudative retinal detachment: coat's (uni and boys)
    • coloboma
    • cataract
  8. Management
    • minimise pre term labour
    • minimum use of O2
    • prevention of complications
    • screenin
  9. tx for ROP?
    • laser photocoagulation: destroys new vessels and seals leaks
    • cryotherapy: destroy ab tissue, reduces risk of RD
    • scleral buckle and vitrctomy
    • VEGF inhibitors
  10. Complications of ROP?
    • poor va
    • myopia
    • strabismum/amb
    • macular dragging by scar tissue

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