PRESENTED BY,MS.L.SOUNDARYAM.SC.NURSING (PEDIATRICS)

Retinopathy of Prematurity (ROP)

(OR)

(Retrolental Fibroplasia)

Retinopathy of prematurity (ROP) is a disease that primarily occurs in premature babies. It causes abnormal blood vessels to grow in the retina, the layer of nerve tissue in the eye that enables us to see. This growth can cause the retina to detach from the back of the eye, leading to blindness.

PATHOPHYSIOLOGY

GREATER AFFINITY OF O2

VIT.E ANTIOXIDANT DEFICIENT IN PREMATURE INFANTS

AFTER BIRTH THE HIGHER CONCENTRATION OF O2 (OVER A

PERIOD OF TIME)

ACTS UPON THE PREMITIVE VASCULAR OF THE EYES AND CAUSES

VASOCONSTRICTION OF THE RETINAL CAPILLARIES LEADING TO AN GROWTH

OF THESE VESSELS

RETINAL VEINS DILATE AND BECOME TORTUOUS

NEW VESSELS DEVELOP TOWARDS THE LENS, THE AQUES AND VITREOUS

HUMORS BECOME TURBID

EDEMA OF THE RETINA AND HEAMORRHAGE WITH

EXUDATE INTO THE RETINA

STRUCTURE SEPARETES FROM THE INNER SURFACE OF THE EYE

RETINA DETACHES AND FLOATS (MOVES) FORWARD IN THE EYE

RETINA BECOME ATROPIC (A COMPLETELY DETACHES AND USELESS FIBROTIC MASS)

BLINDNESSNESS MAY OCCUR

ZONES

EXTENT

STAGESSTAGE -0

STAGES

Stage One – A line of demarcation between the vascular and avascular retina

Stage Two – The line comes a ridge

Stage Three – The ridge is associated with neonvascularization entering the vitreous

STAGE FOUR- PARTIAL RETINAL DETACHMENT

STAGE FIVE- TOTAL RETINAL DETACHMENT

ASSESSMENT

History collectionPhysical

examination

*Opthalmoscopic examination

*Retinal examination

Optical Coherence Tomography (OCT)

Noninvasive

Usually forms

2-D images

3-D pictures

can be

formed

Treatment

Treatment should start within 72 hours of the eye exam

“Plus disease” babies

need immediate treatmentCryotherapy (freezing) Laser therapy Surgery is needed if the retina

detaches Plus Disease

Prevention of severe disease

• Primary – decrease the number of infants born at the gestations with highest risk

• Secondary -An agent that will prevent the retinal blood vessel drop out after birth in very premature infants

• Limit the vaso-proliferative phase• Safe oxygen administration

NURSING MANAGEMENT

Cyanotic infants who need 02 therapy do not require an arterial PO2 much higher than 50mmhg

<70mmhg, inspired 02 concentration should be reduced immediately

Continuous trans-cutaneous Pa02 electrodes is of vital importance in monitoring PaO2 levels

Provide support to the parents and explain their doubts.

THANK YOU