Please note: I am NOT a medical doctor, I am merely a mother of a former 24 weeker who spent 115 days in the NICU and researched this topic as much as I could to make the most informed decision I could.
Retinopathy of Prematurity or ROP is a disease of the eyes that can effect premature infants by causing the blood vessels of the eye to grow incorrectly. ROP can range from mild to severe forms. If not treated properly this can lead to complete retinal detachment and complete blindness.
*Interesting ROP fact*
On May 13, 1950 Calvin Judkins and Lula Mae Hardaway gave birth to their third child. This child was born six weeks prematurely and spent the first weeks of life in an incubator. This child, a boy named Stevland Hardaway Judkins, was diagnosed with ROP shortly after birth which led to complete retinal detachment, this child has been blind since then. We now all know this child by the name of Stevie Wonder.
ROP BASICS - UNDERSTANDING ROP
Stages of ROP
ROP is classified in "Stages" which can range from zero to five. Zero being the lowest and five being the most severe.
- Stage Zero ROP - Stage Zero is what would be a normal eye with immature blood vessels. At this stage the doctors will typically just examine the eyes every other week or possibly weekly to make sure there is no further progression and ROP does not appear.
- Stage One ROP - Stage One is the most mild form of ROP meaning there is some presence of ROP but very small. At this stage doctors will begin to watch the ROP more closely then before and your child will most likely be visited by an ophthalmologist every week.
- Stage Two ROP - Stage Two is a more moderate form of ROP and again at this Stage your child's ophthalmologist will continue to exam the eyes weekly. At this stage they may start discussing options that will need to be taken should the ROP continue to progress. It is possible for ROP to regress at this stage and no further action will be need, although many times this is not the case.
- Stage Three ROP - Stage Three is a more severe form of ROP and may lead to retinal detachment. At this point your child's ophthalmologist will begin to discuss options with you on what should be done next. There is typically three ways that this can be treated. Below you will see I have done some research on each method and listed some of the sites and sources I found on the subject. It is up to you as a parent to speak with your child's ophthalmologist and discuss which of these options is best for your individual child's needs.
- Stage Four ROP - Stage Four is partial detachment of the retina. When Stage Four ROP has been diagnosed they will break this down into two separate subcategories, 4A and 4B. Stage 4A ROP is partial retinal detachment that does not include the fovea (the fovea, or fovea centralis, is a small dip in the back of the eye which is responsible for sharpness in vision) Stage 4B ROP is fovea-off partial retinal detachment.
- Stage Five ROP - Stage Five is the most severe form of ROP and means there has been total retinal detachment. If you child is diagnosed with Stage Five ROP it is important that you discuss the options and outcomes with your child's ophthalmologist.
Remember it is always a good idea to ask for a second opinion no matter what disease you are dealing with and this includes ROP. Remember to ask questions and do your home work
ROP and Zones
There are different Zones that ROP can occur.
***When my daughter, Vivian, was diagnosed with ROP I searched the web looking for good information and our options, we decided that the best route for us was using Avastin injections. This injection is the non-surgical route to treat ROP. Currently there have been no long term studies done as to the effects of Avastin injections to treat ROP. Our daughter must be checked every week until the blood vessels have fully matured and it will take longer for them to mature as the injection actually slows the growth of the blood vessels. However, after talking with our ophthalmologist I felt that this was the best route for us to take. If you have concerns of these possible effects you should talk with your preemie's ophthalmologist. The Trial Lawyer Resource Center has a great article regarding this some of the risks associated with Avastin Treatments.
