Sen Parveen, Jain Smriti, Bhende Pramod
Shri Bhagwan Mahavir Vitreoretinal Services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India.
Taiwan J Ophthalmol. 2018 Oct-Dec;8(4):205-215. doi: 10.4103/tjo.tjo_61_18.
Retinopathy of prematurity (ROP) is one of the most common causes of preventable blindness in children. In spite of the availability of various treatment options, and favorable results with timely intervention, many infants present to the ophthalmologists in the advanced end stage of the disease due to lack of awareness especially in the developing nations. This blinding or Stage 5 of ROP presents with total retinal detachment and has to be managed surgically. The surgical techniques for Stage 5 ROP are unique and demanding. The successful anatomical results after surgery are only seen in 20%-50% of cases. In spite of a successful anatomical result, the visual outcome may be slow and limited. The use of newer pharmacological adjuncts has shown promising results. Because of heterogeneity of presentation of the disease severity, a genetic predisposition has also been proposed. A concerted effort from the pediatricians, ophthalmologists, and healthcare workers is required to establish effective screening and treatment guidelines to prevent blindness due to ROP. Till then surgical management has to be done. Parents must be educated regarding the limited visual benefits of surgery and the need for prolonged follow-up. This review gives a comprehensive overview of the pathogenesis, clinical aspects, surgical interventions, and their outcomes and future prospects of Stage 5 ROP.
早产儿视网膜病变（ROP）是儿童可预防失明的最常见原因之一。尽管有多种治疗选择，且及时干预能取得良好效果，但由于缺乏认识，尤其是在发展中国家，许多婴儿在疾病晚期才被转诊至眼科医生处。这种致盲性的ROP 5期表现为视网膜完全脱离，必须通过手术治疗。5期ROP的手术技术独特且要求高。手术后仅20%-50%的病例能获得成功的解剖学结果。尽管解剖学结果成功，但视觉预后可能缓慢且有限。使用新型药物辅助治疗已显示出有前景的结果。由于疾病严重程度表现的异质性，也有人提出了遗传易感性。儿科医生、眼科医生和医护人员需要共同努力，制定有效的筛查和治疗指南，以预防ROP导致的失明。在此之前，必须进行手术治疗。必须让家长了解手术有限的视觉益处以及长期随访的必要性。本综述全面概述了5期ROP的发病机制、临床方面、手术干预及其结果和未来前景。
