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R etrolental Fibroplasia

R etrolental Fibroplasia. Retinopathy of Prematurity Disturbance in the retinal vascularization in premature infants May be acute or chronic Usually bilateral, often asymmetric Causative role of supplemental oxygen. R etrolental Fibroplasia. Major risk factors Decreasing gestational age

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R etrolental Fibroplasia

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  1. RetrolentalFibroplasia • Retinopathy of Prematurity • Disturbance in the retinal vascularization in premature infants • May be acute or chronic • Usually bilateral, often asymmetric • Causative role of supplemental oxygen

  2. RetrolentalFibroplasia • Major risk factors • Decreasing gestational age • Decreasing birth weight • Other associated risk factors • Acidosis • Apnea • PDA • Septicemia • Blood transfusions • Intraventricularhemorrhage

  3. RetrolentalFibroplasiaClinical Manifestations Reference: Nelson Textbook of Pediatrics. 18th Edition. 2007.

  4. RetrolentalFibroplasiaClinical Findings Reference: Nelson Textbook of Pediatrics. 18th Edition. 2007.

  5. RetrolentalFibroplasia

  6. Stage 1 ROP Stage 2 ROP Stage 3 ROP

  7. Stage 4 ROP Stage 5 ROP

  8. Stage 5 ROP

  9. RetrolentalFibroplasiaDiagnosis • Recommendations • Systematic serial ophthalmologic examinations of infants at risk • Infants weighing <1500g at birth • Infants born before 31 weeks AOG • Infants weighing >1500g at birth who have an unstable clinical course Reference: Nelson Textbook of Pediatrics. 18th Edition. 2007.

  10. RetrolentalFibroplasiaDiagnosis • Recommendations • Initial examination should be performed at 4th to 6th week of chronological age • ROP is diagnosed most often at 32nd to 44th week after conception. • Screening should continue until the retina is fully vascularized, until the changes of ROP have undergone spontaneous resolution, or until appropriate treatment has been given. Reference: Nelson Textbook of Pediatrics. 18th Edition. 2007.

  11. RetrolentalFibroplasiaTreatment • Early Treatment of Retinopathy of Prematurity Study • Recommends treatment for infants with Stage 2 disease with vascular tortuosity and engorgement • Laser – treatment modality of choice • Vitrectomy and lensectomy in cicatricial disease References: Nelson Textbook of Pediatrics. 18th Edition. 2007. Vaughan & Asbury’s General Ophthalmology 17th Edition. 2008.

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