Greisen G O, Fledelius H C
Neonatalafdeling GN 5024, Rigshopitalet, København.
Ugeskr Laeger. 1993 Nov 15;155(46):3746-50.
Retinopathy of prematurity (ROP) is a complication of very preterm birth. The problem is relatively common in Denmark; although only 10 infants are blinded each year, this represents a high incidence in international comparison. The very complete Danish registry of the blind may be partly responsible. The incidence remains high due to the increased survival rate in very preterm infants. Although free oxygen radical injury most likely plays a central role, it is doubtful if reduction of supplementary oxygen under careful monitoring can reduce the risk of ROP. Unfortunately, the most preterm and most unstable infants, who are at highest risk of ROP, are also particularly exposed to hypoxia. It is possible that light increases the risk, even for other reasons it is recommended to reduce the intensity of light in the ward or to use eye pads, at least some of the time. There is no effective drug prevention, in particular there is no evidence that vitamin E is useful. Cryotherapy, however, in the acute phase of threshold disease (stage 3+), can reduce the risk of permanent loss of central vision from about 50% to 25%. Effective screening for ROP has become part of modern neonatology. Diagnosis as well as cryotherapy requires particular skill and experience.