Does My Child Really Need to Wear These Glasses? A Review of Retinopathy of Prematurity and Long-Term Outcomes

Dawn R. Kuerschner, MS, NNP, RNC

Disclosures

NAINR. 2003;3(3) 

In This Article

History of Retinopathy of Prematurity

ROP was first identified in the 1940s, when physicians noted visually impaired infants had grayish membranes on their retinas.[2,3] As more cases were identified, the term retrolental fibroplasia (RLF) was coined to describe this finding. Serial examinations revealed infants were not born with the condition rather environmental and/or clinical factors led to the development of the disorder. By the early 1950s, RLF was rapidly becoming the leading cause of pediatric blindness.[4] By the late 1950s and into the early 1960s, RLF literally disappeared because of limitations in oxygen use and more vigilant monitoring.[5] Because of this, ROP was rarely taught in medical schools.[5] However, with the advances in technology and the advent of neonatal intensive care units (NICUs), RLF has re-emerged at astonishing rates.

Oxygen exposure was one of the factor originally found to influence the development of RLF and has been the focus of much of the subsequent research. Other early factors thought to contribute to RLF included exposure to light, bacteremia, anemia, vitamin deficiencies, electrolyte disturbances, and hypercapnia.[6]

RLF incidence began to rise in the 1980s. At that time, there was no consensus on how to track the progression or severity of RLF nor was there any universal guidelines on intervention.[3] In 1981, ophthalmologists and neonatalogists met at the international level to discuss development of a new classification system. By 1983, a new classification system, International Classification of ROP (ICROP), was established and published in both fields of literature the following year.

The new classification system gave ophthalmologists a method to document ROP in a manner that was interchangeable between persons and allowed accurate reporting and documentation for clinical trials. It was also at this time that the term ROP replaced RLF as the accepted medical terminology describing this disorder.[6]

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