Retinopathy of Prematurity Workup

  • Author: Mounir Bashour, MD, CM, FRCS(C), PhD, FACS; Chief Editor: Hampton Roy Sr, MD   more...
 
Updated: Jan 31, 2012
 

Imaging Studies

  • In 2008, a telemedicine study showed that single-image and multiple-image telemedicine examinations perform comparably in the determination of a recommended follow-up interval and in the detection of plus disease.[11] In the future, there will likely be an increase and development of screening protocols, particularly in areas with limited access to ophthalmic care.[11]
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Procedures

  • A dilated fundus examination with scleral depression is necessary. The instruments used are a Sauer speculum (to keep the eyes gently open), a Flynn scleral depressor (to rotate and depress small eyes), and a 28-diopter lens (for proper identification of zones).
  • The first part of the examination should be external, with identification of iris rubeosis, if present. The next part of the examination should be the posterior pole, with identification of any plus disease or straightening of the vascular arcades. The eye is rotated to identify the presence or absence of zone 1 disease (if the ridge and the optic nerve are present in the same view, this usually implies zone 1). If the nasal vessels are not at the nasal ora serrata, this is still zone 2. If the nasal vessels have reached the nasal ora serrata, the eye is in zone 3.
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Contributor Information and Disclosures
Author

Mounir Bashour, MD, CM, FRCS(C), PhD, FACS  Assistant Professor of Ophthalmology, McGill University; Clinical Assistant Professor of Ophthalmology, Sherbrooke University; Medical Director, Cornea Laser and Lasik MD

Mounir Bashour, MD, CM, FRCS(C), PhD, FACS is a member of the following medical societies: American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus, American College of International Physicians, American College of Surgeons, American Medical Association, American Society of Cataract and Refractive Surgery, American Society of Mechanical Engineers, American Society of Ophthalmic Plastic and Reconstructive Surgery, Biomedical Engineering Society, Canadian Medical Association, Canadian Ophthalmological Society, Contact Lens Association of Ophthalmologists, International College of Surgeons US Section, Ontario Medical Association, Quebec Medical Association, and Royal College of Physicians and Surgeons of Canada

Disclosure: Nothing to disclose.

Coauthor(s)

Johanne Menassa, MD  Staff Physician, Department of Ophthalmology, University of Laval Hospital, Quebec City

Disclosure: Nothing to disclose.

C Corina Gerontis, MD  Consulting Staff, Departments of Pediatrics and Ophthalmology, Schneider Children's Hospital/Long Island Jewish Medical Center

C Corina Gerontis, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus, and American Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

V Al Pakalnis, MD, PhD  Professor of Ophthalmology, University of South Carolina School of Medicine; Chief of Ophthalmology, Dorn Veterans Affairs Medical Center

V Al Pakalnis, MD, PhD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and South Carolina Medical Association

Disclosure: Nothing to disclose.

Simon K Law, MD, PharmD  Associate Professor of Ophthalmology, Jules Stein Eye Institute, University of California, Los Angeles, David Geffen School of Medicine

Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology

Disclosure: Nothing to disclose.

Steve Charles, MD  Director of Charles Retina Institute; Clinical Professor, Department of Ophthalmology, University of Tennessee College of Medicine; Adjunct Professor of Ophthalmology, Columbia College of Physicians and Surgeons; Clinical Professor Ophthalmology, Chinese University of Hong Kong

Steve Charles, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Retina Specialists, Club Jules Gonin, Macula Society, and Retina Society

Disclosure: Alcon Laboratories Consulting fee Consulting; OptiMedica Ownership interest Other; Topcon Medical Lasers Consulting fee Consulting

Lance L Brown, OD, MD  Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri

Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD  Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

References

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  2. Campbell K. Intensive oxygen therapy as a possible cause for retrolental fibroplasia. A clinical approach. Med J Austr. 1951;2:48-50.

  3. Kretzer FL, Hittner HM. Retinopathy of prematurity: clinical implications of retinal development. Arch Dis Child. Oct 1988;63(10 Spec No):1151-67. [Medline].

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  5. Csak K, Szabo V, Szabo A, et al. Pathogenesis and genetic basis for retinopathy of prematurity. Front Biosci. Jan 1 2006;11:908-20. [Medline].

  6. Fielder AR, Shaw DE, Robinson J, et al. Natural history of retinopathy of prematurity: a prospective study. Eye. 1992;6 (Pt 3):233-42. [Medline].

  7. Varughese S, Gilbert C, Pieper C, et al. Retinopathy of prematurity in South Africa: an assessment of needs, resources and requirements for screening programmes. Br J Ophthalmol. Jul 2008;92(7):879-82. [Medline].

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  9. Wallace DK, Freedman SF, Hartnett ME, Quinn GE. Predictive Value of Pre-plus Disease in Retinopathy of Prematurity. Arch Ophthalmol. May 2011;129(5):591-6. [Medline].

  10. Tolsma KW, Allred EN, Chen ML, et al. Neonatal bacteremia and retinopathy of prematurity: the ELGAN study. Arch Ophthalmol. Dec 2011;129(12):1555-63. [Medline].

  11. Lajoie A, Koreen S, Wang L, et al. Retinopathy of prematurity management using single-image vs multiple-image telemedicine examinations. Am J Ophthalmol. Aug 2008;146(2):298-309. [Medline].

  12. Dempsey E, McCreery K. Local anaesthetic eye drops for prevention of pain in preterm infants undergoing screening for retinopathy of prematurity. Cochrane Database Syst Rev. Sep 7 2011;9:CD007645. [Medline].

  13. Repka MX, Hardy RJ, Phelps DL, et al. Surfactant prophylaxis and retinopathy of prematurity. Arch Ophthalmol. May 1993;111(5):618-20. [Medline].

  14. Wu WC, Yeh PT, Chen SN, Yang CM, Lai CC, Kuo HK. Effects and complications of bevacizumab use in patients with retinopathy of prematurity: a multicenter study in taiwan. Ophthalmology. Jan 2011;118(1):176-83. [Medline].

  15. Mintz-Hittner HA, Kennedy KA, Chuang AZ. Efficacy of intravitreal bevacizumab for stage 3+ retinopathy of prematurity. N Engl J Med. Feb 17 2011;364(7):603-15. [Medline].

  16. Cryotherapy for Retinopathy of Prematurity Cooperative Group. Multicenter trial of cryotherapy for retinopathy of prematurity. One-year outcome--structure and function. Arch Ophthalmol. Oct 1990;108(10):1408-16. [Medline].

  17. Early Treatment For Retinopathy Of Prematurity Cooperative Group. Revised indications for the treatment of retinopathy of prematurity: results of the early treatment for retinopathy of prematurity randomized trial. Arch Ophthalmol. Dec 2003;121(12):1684-94. [Medline].

  18. Laser ROP Study Group. Laser therapy for retinopathy of prematurity. Arch Ophthalmol. Feb 1994;112(2):154-6. [Medline].

  19. Phelps DL. Retinopathy of prematurity: an estimate of vision loss in the United States--1979. Pediatrics. Jun 1981;67(6):924-5. [Medline].

  20. Repka MX, Tung B, Good WV, et al. Outcome of eyes developing retinal detachment during the Early Treatment for Retinopathy of Prematurity Study (ETROP). Arch Ophthalmol. Jan 2006;124(1):24-30. [Medline].

  21. Reynolds JD, Hardy RJ, Kennedy KA, et al. Lack of efficacy of light reduction in preventing retinopathy of prematurity. Light Reduction in Retinopathy of Prematurity (LIGHT-ROP) Cooperative Group. N Engl J Med. May 28 1998;338(22):1572-6. [Medline].

  22. Schaffer DB, Palmer EA, Plotsky DF, et al. Prognostic factors in the natural course of retinopathy of prematurity. The Cryotherapy for Retinopathy of Prematurity Cooperative Group. Ophthalmology. Feb 1993;100(2):230-7. [Medline].

  23. Section on Ophthalmology American Academy of Pediatrics, American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus. Screening examination of premature infants for retinopathy of prematurity. Pediatrics. Feb 2006;117(2):572-6. [Medline].

  24. Supplemental Therapeutic Oxygen for Prethreshold Retinopathy Of Prematurity (STOP-ROP), a randomized, controlled trial. I: primary outcomes. Pediatrics. Feb 2000;105(2):295-310. [Medline].

  25. The Committee for the Classification of Retinopathy of Prematurity. An international classification of retinopathy of prematurity. Arch Ophthalmol. Aug 1984;102(8):1130-4. [Medline].

 
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Retinopathy of prematurity consultation form and fundus drawing.
 
 
 
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