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How to treat Retinopathy of Prematurity?

Q: My baby girl was born on 3-6-2001(premature of 31 weeks with weight of 1.34kg.On getting her eyes checked on 27.10.2001 after four months of her birth, the doctors told us that she sufferred from Retina damage at fifth stage and treatment of Retina damage is possible upto fourth stage only. We seek your kind advice on th following points:- 1.How much time Retina takes to damage upto fifth stage after its infection i.e from First stage to fifth stage?. 2.Was it necessary to get eyes checked up of above pre-mature baby periodically to save retina damage and if so after how much tima and upto which age.please send us the reply of these questions as early as possible.Thanks

A:Your baby has Retinopathy of Prematurity (ROP) and I am sorry to learn of her suffering. In the US, the recommendations on how to deal with examinations and treatment of premature babies are based on a very elaborate clinical study called the Cryo-ROP study. These recommendations are considered the gold standard and there must exist a remarkably sound reason to deviate from these recommendations anywhere in the world.The initial eye (dilated retina - fundus) examination of an infant weighing less than 1.5 kg should take place between 4 to 6 weeks after birth. If no ROP disease is present then another exam is performed after 4 weeks. If however ROP disease (any stage) is present, then weekly examinations are done to see if the ROP disease is progressive and to see if has progressed to threshold disease (defined as stage 3 plus ROP). If there is indeed threshold ROP (stage 3 plus) present then cryo or laser treatment is immediately done to prevent further progression of disease. Cryo or laser treatment will reduce the vision loss by about 46% - A REMARKABLE DIFFERENCE. Therefore it is of paramount importance to identify the disease within 6 weeks of birth and to treat it immediately if it progresses to threshold disease. One should not wait for the ROP disease to progress to beyond stage 3 plus to start treatment.In the Cryo-ROP study about 90% of the eyes reached threshold disease (stage 3 plus) between 33.6 weeks and 42 weeks postconception (therefore count the weeks forward since you became pregnant). Since your child was 31 weeks gestational age, I would presume that the stage 3 plus disease happened when she was betwen 3 to 12 weekis of age. As you can see the greatest value of initial eye exam is between 4 to 6 weeks. .You must consult a retinal surgeon who is experienced in surgeries on such difficult eyes and please do so as soon as possible.


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