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Retrolental fibroplasia

Retinopathy of prematurity (ROP), also known as retrolental fibroplasia (RLF), is a disease of the eye that affects prematurely born babies. It is thought to be caused by disorganised growth of retinal blood vessels resulting in scarring and retinal detachment. more...

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ROP can be mild and may resolve spontaneously, but may lead to blindness in serious cases. Oxygen toxicity may contribute to the development of ROP.

International Classification of Retinopathy of Prematurity (ICROP)

The system used for described the findings of ROP is entitled, The International Classification of Retinopathy of Prematurity (ICROP). ICROP "demarcated the location of the disease into zones (1, 2, and 3) of the retina, the extent of the disease based on the clock hours (1-12), and the severity of the disease into stages (0-5)" .

Symptoms and prognosis

In preterm infants, the retina is often not fully formed. ROP occurs when abnormal tissue forms between the central and peripheral retina. There are 5 progressive stages to ROP. Stage 1 is mild and may resolve on its own without severe vision loss; stage 5 is severe and usually results in retinal detachment.

Multiple factors can determine how fast a patient progresses through the stages, including overall health, birth weight, the stage of ROP at initial diagnosis, and the presence or absence of "plus" disease. "Plus" disease occurs when the abnormal vessels in the retina invade other areas of the eye, greatly increasing the risk of retinal detachment.

The abnormal vessel growth often subsides spontaneously, but can progress to retinal detachment and vision loss in patients with extremely low birth weight. Patients with ROP are at greater risk for glaucoma, cataracts and myopia later in life, and should be examined yearly to help prevent and treat these conditions.

Treatment

  • Cryotherapy
  • "Indirect laser"
  • scleral buckle and/or vitrectomy may be considered for severe ROP with retinal detachment

Read more at Wikipedia.org


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Association of human milk feedings with a reduction in retinopathy of prematurity among very low birthweight infants - Abstract
From Alternative Medicine Review, 12/1/01

INTRODUCTION: With the increased survival of very low birthweight (VLBW) infants, weighing less than 1500 g at birth, the incidence of retinopathy of prematurity (ROP), a significant cause of blindness among children in the United States, is also increasing. Preterm infants with a positive diagnosis of ROP during the perinatal period are at increased risk for ocular abnormalities and for deficits in visual function during later periods of development. Human milk has many antioxidant constituents including inositol, vitamin E, and beta-carotene that may protect against the development of ROP. OBJECTIVE: The objective of this study was to examine the effect of human milk feedings on the incidence of ROP among VLBW infants. STUDY DESIGN: Observational cohort study. PARTICIPANTS: We identified 283 VLBW infants admitted to the Georgetown University Medical Center Neonatal Intensive Care Unit (NICU) from January 1992 through September 1993. All infants surviving to receive enteral feeding and ophthalmologic examinations for ROP (n=174) were included in the analysis. METHODS: Type of feeding (human milk versus exclusive formula), presence of ROP, and potential confounding variables were abstracted retrospectively from medical records. ROP was present if any stage of ROP was diagnosed at any age during the initial NICU hospitalization; each case was counted once based on the worse severity of ROP in either eye. Multiple logistic regression was used to control for confounders. MAIN OUTCOME MEASURE: ROP. RESULTS: Major predictors of ROP were similar in both feeding groups including gestational age, days on mechanical ventilation, and total number of days on supplemental oxygen. The incidence of ROP differed significantly by type of feeding (human milk - 41.0% vs. formula -63.5%, p=0.005). Human milk feeding independently correlated with a reduced odds of ROP (OR: 0.42, 95% CI: 0.19 to 0.93) (p=0.03), controlling for gestational age, duration of supplemental oxygen therapy, 5-minute Apgar score, and race. Human milk feeding independently correlated with a reduced odds of ROP (OR: 0.46, 95% CI: 0.18 to 0.91) (p=0.03), controlling for birthweight, duration of supplemental oxygen therapy, 5-minute Apgar score, and race. CONCLUSION: Human milk feeding among VLBW infants was associated with a lower incidence of ROP compared to exclusively formula-fed VLBW infants after adjusting for confounding variables.

Hylander MA, Strobino DM, Pezzullo JC, Dhanireddy R. J Perinatol 2001;21:356-362.

COPYRIGHT 2001 Thorne Research Inc.
COPYRIGHT 2002 Gale Group

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