Retinopathy of Prematurity Stages

First diagnosed in 1942, retinopathy of prematurity (ROP) is a disease that usually develops, as its name suggests, in the premature baby. It occurs in infants weighing less than about 2 and 3/4 pounds and who are born before 31 weeks of gestation (normal gestation is 38 to 42 weeks.)

Retinopathy of prematurity can lead to vision impairment for a person's life and may cause blindness. It occurs when the blood vessels of the retina, the tissue lining the back of the eye, grow and spread abnormally throughout the retina and into the eye. Such abnormal blood vessels are fragile and can leak.

This scars the retina. When the scar shrinks, it pulls the retina out of its normal position and may lead to retinal detachment. Retinal detachment impairs vision and is the main cause of blindness in children whose disease is at this stage and is untreated.

Stages of Retinopathy of Prematurity

The following describes what the ophthalmologist sees looking through the ophthalmoscope at the various stages of ROP:

  • Stage I - Demarcation Line: This is the mildest form of ROP. The doctor sees a flat line delineating vascularized (having blood vessels) from non-vascularized parts of the retina. This stage usually resolves on its own.
  • Stage II - Intraretinal Ridge: A slight three-dimensional ridge has arisen along the demarcation line. At this stage, blood vessel growth is moderately abnormal. The baby's vision will usually improve to normal by itself.
  • Stage III - Ridge with Extraretinal Fibrovascular Proliferation: Growth of the blood vessels has extended beyond the surface of the retina toward the center of the eye. Some babies' eyes will become normal at this stage without treatment. But in other cases, the disease is said to be at a "plus" stage. This means that the blood vessels of the retina have become enlarged and twisted. If treated at this stage, the disease is less likely to progress to retinal detachment.
  • Stage IV - Partial Retinal Detachment: Bleeding has caused scar tissue to form and pull part of the retina away from the underlying area of support tissue and the wall of the eye.
  • Stage V - Total Retinal Detachment: This is the end stage of the disease. The retina has become completely detached from the wall of the eye. If not treated at this stage, the child will have minimal vision at best and might become blind.

About 90 percent of infants with retinopathy of prematurity will improve by themselves and have no resulting problems. However, between 1,100 and 1,500 infants each year have ROP severe enough to need medical treatment. Another 400 to 600 babies become legally blind annually from ROP.

For more information, contact our ROP lawyers today.