This presentation contains basic information on ROP

1. NAME:
NAMRATA DEEPAK GIRKAR.
COURSE:
B.OPTOMETRY.(2ND YEAR.)
ROLL NO.:
PARB-OPT1F004.
TOPIC:
RETINOPATHY OF PREMATURITY.

2. RETINOPATHY- Non-inflammatory disease of the retina.
PREMATURITY-Bilateral proliferative retinopathy,occurring in
premature infants.
DEFINATION:
A premature infant of low birth weight exposed to a
high ambient oxygen concentration.

3. ETIOPATHOGENESIS:
Vascularization of peripheral retina.
In the normal development of retina , the vessels reach the retina after 8 months
of gestation and temporal periphery about 1 month after delivery.

4. LOCATION OF DISEASE
(ZONES OF INVOLVEMENT)
OF ROP:
-Bounded by an imaginary circle.
-Extends from the edge of zone I.
-Consists of residual temporal crescent.
ZONE
I
ZONE
II
ZONE
III

5. LOCATION OF DISEASE
(ZONES OF INVOLVEMENT)
OF ROP:
Division of retina into zones (l,ll,lll) and clock hour positions to depict
involvement in retinopathy of prematurity.
Contd…

7. Progression of retinopathy of prematurity

8. STAGE I: Demarcation line.
Vascularised retina
Demarcation line
Avascular retina

9. STAGE II: Ridge.
Isolated neovascular tufts
Ridge
An elevated ridge of mesenchymal tissue is present at the border of the vascular and
avascular retina

10. STAGE III: Extra retinal fibrovascular proliferation.
Severe extra retinal fibrovascular proliferation.

11. STAGE IVA: Macula is not involved.

12. STAGE IVB: Macula is involved.

13. STAGE V:Retinal Detachment.
Detached Retina

14. OTHER FEATURES:
1. Plus Disease-
Signifies a tendency to progress.
Vascular dilation in retinopathy of prematurity
‘plus’ disease

15. 2.Pre-plus disease-
Abnormal dilatation which is not sufficient to be
designated as plus disease.
3.Rush disease-
Refers to ROP located in zone I with plus disease.
Aggressive posterior ROP

16. 4.Threshold disease-
Refers to stage III ROP.
Threshold ROP in premature infant with stage 3
disease bordering zone 1 and zone 2 and the presence
of plus disease

17. DIFFERENTIAL DIAGNOSIS:
Familial exudative vitreoretinopathy (FEVR).
Advanced retrolental fibroplasia.
SCREENING AND MANAGEMENT:
 Mature retina –
Is labelled when the vessels have reached within one
disc diameter of both nasal and temporal ora-serrata.
 Immature retina-
Is labelled when the vessels are short of one disc
diameter of the nasal or temporal ora but ROP is not developed
yet.
 Reninopathy of prematurity-
ROP is detected.

18. TREATMENT:
 Laser Photocoagulation.
Laser photocoagulation for threshold ROP-
A. Threshold eye prior to laser therapy.
B. Immediately after laser therapy.
C. 1 week after laser therapy.
D. 3 months after laser therapy.

19. REFERENCE:
 Comprehensive Ophthalmology- By A.K. Khurana.
 Clinical Ophthalmology- By Jack J. Kanski.
 www.google.com