Retinopathy of Prematurity

In the early 1940s, premature infants with breathing difficulties began to be treated with oxygen, and 12 years elapsed before it was realized that the retinopathy seen in premature children was caused by this treatment. During the course of oxygen therapy in a premature infant, the retinal vessels become narrowed and the optic disc becomes pale. When the oxygen treatment is stopped, the retinal vessels become engorged and new vessels grow from the peripheral arcades in the extreme periphery of the fundus. This growth of abnormal vessels leads to vitreous haemorrhage, retinal detachment and fibrosis of the retina. The infant can rapidly become blind, although some are minimally affected. The management of the condition now involves screening of those children at risk and monitoring of blood oxygen levels. When the condition occurs, treatment with cryotherapy to the peripheral retina has been shown to be beneficial. Now that children are being born at an earlier and earlier stage, it seems that extreme prematurity runs the risk of blindness from this cause even in the absence of supplementary oxygen.

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