Rop: Treatment, Procedure, Cost and Side Effects

Retinopathy of Prematurity (ROP) is also known as Terry syndrome, Retrolental fibroplasia (RLF).

ROP is an eye disorder caused by abnormal blood vessel growth in the light sensitive part of the eyes (retina) of premature infants. There are various risk factors of ROP such as Prematurity, High exposure to oxygen, Low birth weight, Various types of infections, Cardiac defects. ROP generally affects infants born before week 31 of pregnancy or at birth. If your child has mild retinopathy of prematurity (Stage 1 or 2), the abnormal retinal blood vessels usually heal on their own sometime in the first four months of life. But if the ROP worsens, he may need treatment.

However, ROP treatment depend on its severity of the child's condition. Recent treatment includes the combination of therapy and drugs which include cryotherapy, freezing retinal tissues, laser therapy, scleral buckling, a surgery during which a band is placed around the eye to hold the retina to the eye's inner layers, prescription eyewear, including glasses or contact lenses, for life and assistive technologies, such as special computer programs or voice-activated equipment, for those with severe loss of vision or total blindness

Studies have shown that anti-VEGF drugs may improve outcomes when used in conjunction with laser therapy.

With early detection of ROP, we can closely follow the progress of the disease to determine the right time to begin treatment, if needed, for the best results for your baby's eyes.

Laser Therapy or Photocoagulation:

It is the standard treatment for advanced ROP. The ophthalmologist uses a diode laser mounted on the indirect ophthalmoscope to make tiny “burns” in the periphery of the retina. laser therapy burns away the area around the edge of the retina, which has no normal blood vessels. The ophthalmologist uses a diode laser mounted on the indirect ophthalmoscope to make tiny “burns” in the periphery of the retina, to prevent further growth of abnormal blood vessels.

Laser surgery also requires general anesthesia, which may be risky for preterm infants. The child is examined every 2 to 3 weeks. If the ROP continues to worsen, your child may need additional laser treatments or possibly eye surgery.

Cryotherapy or Cryopexy:

This was the first treatment for ROP. Cryotherapy uses an instrument to freeze a specific part of the eye that extends beyond the edges of the retina. It is used rarely now because outcomes from laser therapy are generally better. As with laser therapy, the treatment destroys some peripheral vision and must be done under general anesthesia. The procedure aims to save the child's central vision, which is necessary for things like reading and writing.

Eye Surgery:

If your child's retinal becomes partly or completely detached, you may be recommended to go for treatment, usually scleral buckling or vitrectomy. Scleral buckling involves placing a silicone band around the eye and tightening it until the retina is close enough to the wall to reattach itself. The band, called a scleral buckle, can be left in place to protect the eye for months, or sometimes years. Vitrectomy involves removing the vitreous (the gel-like substance that fills the back of the eye) and replacing it with saline solution or oil. The scar tissue on the retina can then be peeled back or cut away, allowing the retina to flatten back down against the wall of the eye.

The child should seek the treatment as and when ROP symptoms are found. Severe ROP needs to be treated quickly to prevent further damage. This will usually be within 48 hours of the severe ROP being diagnosed although it maybe a little longer if your baby has to be transferred.

People with heart conditions or pregnant women may not be able to go through the more intensive treatments

Laser therapy and cryotherapy can decrease peripheral vision. Your baby may get an infection after surgery. ROP may get worse, even after treatment. Your child may have vision problems as he grows. His vision may be blurry, or he may see floaters. Floaters look like spots, cobwebs, strings, or specks. He may see flashes of light. Your baby may have blurred vision or blindness. ROP can cause retinal detachment. This is when your baby's retina separates from the back of his eye. A detached retina can lead to vision loss.

Laser therapy and cryotherapy can decrease peripheral vision. Your baby may get an infection after surgery. ROP may get worse, even after treatment. Your child may have vision problems as he grows. His vision may be blurry, or he may see floaters. Floaters look like spots, cobwebs, strings, or specks. He may see flashes of light. Your baby may have blurred vision or blindness. ROP can cause retinal detachment. This is when your baby's retina separates from the back of his eye. A detached retina can lead to vision loss.

Recovering from ROP can take few months depending on the child's condition and the type of treatment done. However, you must consult the doctor often.

Consultancy fee for check-up varies from Rs.500-Rs.1000. Surgery is bit costly, which costs more than Rs. 20,000.

50%-60% of the surgeries are successful, but the child should be regularly tested.