Retinopathy of Prematurity: A NICU Based Approach

Retinopathy of prematurity is a fibrovascular proliferative disorder affecting the peripheral retinal vasculature in premature infants. It is one of the leading causes of preventable childhood blindness across the globe. The world is currently experiencing ROP as third epidemic, where majority of the cases are from middle-income countries. With intensive use of in-vitro fertilisation (IVF) and multiple births, ROP emerging as a significant problem globally. High quality neonatal services, better equipment, improved training, evidence-based screening protocols and access to ROP specialists preventing blindness due to ROP in most of the countries. For more than three decades, improvement in treatment strategy for severe ROP markedly decrease the incidence of ROP related blindness. Current international screening guidelines recommend ROP screening for all premature infants based on birth weight of less than 1501 g or a gestational age of 30 weeks or less, while latest Indian screening guidelines includes all premature infants with birth weight of <2000 grams or gestational age of <34 weeks. Current strategies include adoption of newer screening guidelines, telemedicine and vision rehabilitation.