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Retinopathy of Prematurity (ROP)

Vasoproliferative retinal disease in preterm infants requiring screening and timely intervention to prevent blindness.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Göz Hastalıkları department. Book Appointment →

What is Retinopathy of Prematurity (ROP)?

Retinopathy of prematurity (ROP) is a vasoproliferative disorder of the developing retina in preterm infants. Pathogenesis involves a two-phase process: hyperoxic injury and growth factor suppression in phase I (causing vaso-obliteration), followed by hypoxia-driven VEGF upregulation and pathological neovascularization in phase II.

International Classification of ROP (ICROP) defines disease severity by zone (I, II, III), stage (1-5), plus disease (vascular dilation/tortuosity), and aggressive ROP (formerly aggressive posterior ROP). Stage 4 indicates partial retinal detachment, stage 5 total retinal detachment with poor visual prognosis without intervention.

Universal screening guidelines target infants ≤30-32 weeks gestational age or ≤1500-2000 g birth weight, with first exam at 4 weeks chronological or 31 weeks postmenstrual age (whichever is later). Treatment indications include type 1 ROP (zone I any stage with plus, zone I stage 3 without plus, zone II stage 2-3 with plus). Anti-VEGF (bevacizumab, ranibizumab) and laser photocoagulation are primary modalities. Long-term follow-up is essential due to risks of myopia, strabismus, amblyopia and late retinal detachment.

Symptoms

Asymptomatic — detected only by screening examination
Leukocoria (white pupil) in advanced stages
Strabismus or nystagmus (late finding)
Poor visual fixation or tracking
Microphthalmos in severe cases
Retinal detachment signs (stage 4-5)
Refractive errors (high myopia)
Visual impairment ranging from mild to blindness

Risk Factors

Gestational age <30-32 weeks
Birth weight <1500-2000 g
Prolonged supplemental oxygen therapy
Mechanical ventilation and respiratory distress
Sepsis and necrotizing enterocolitis
Intraventricular hemorrhage
Multiple gestation
Slow postnatal weight gain

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • All preterm infants meeting screening criteria
  • First exam at 4 weeks chronological age or 31 weeks PMA
  • Follow-up examinations per ICROP recommendations
  • Any concerning fundus finding warrants urgent review
  • Plus disease — urgent treatment evaluation
  • Type 1 ROP — treatment within 48-72 hours
  • Aggressive ROP — same-day treatment
  • Long-term follow-up for strabismus, amblyopia, late detachment

Treatment Methods

01
Universal screening with binocular indirect ophthalmoscopy
02
RetCam digital fundus imaging for documentation
03
Telemedicine ROP screening in remote settings
04
Intravitreal anti-VEGF (bevacizumab, ranibizumab) for zone I or AP-ROP
05
Laser photocoagulation of avascular retina (peripheral ablation)
06
Vitrectomy for stage 4-5 retinal detachment
07
Long-term follow-up for myopia, strabismus, amblyopia
08
Optimized neonatal oxygen targeting (SpO2 91-95%)

Which Department to Visit?

You can visit our Göz Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Göz Hastalıkları Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.