Hello and welcome to the Zero to Finals podcast. My name is Tom and in this episode I'm going to be

talking to you about retinopathy of prematurity. And if you want to follow along with written notes on

this topic, you can follow along at zero definals.com slash ROP or in the neonatology section of the Zero to Finals pediatrics book. So let's get straight into it.

Retinopathy of prematurity is a condition affecting preterm and low birth weight babies.

It mostly affects babies born before 32 weeks gestation.

Abnormal development of the blood vessels in the retina can lead to scarring, retinal detachment and blindness. Treatment aims to prevent blindness,

which is why screening for retinopathy of prematurely is so important. Let's start with some basic pathophysiology.

Retinal blood vessel development starts at around 16 weeks gestation and is complete by 37 to 40

weeks gestation. The blood vessels grow from the middle of the retina to the outer area. This vessel formation is stimulated

by hypoxia, which is a normal condition in the retina during pregnancy. When the retina is

exposed to higher oxygen concentrations in a preterm baby, particularly when they're treated with

supplementary oxygen during medical care,

the hypoxic stimulation for normal blood vessel development is no longer there.

When the hypoxic environment reoccurs, the retina responds by producing excessive blood vessels,

which we call neovascularization,

as well as scar tissue on the retina.

These abnormal blood vessels may regress and leave the retina without a blood supply,

and the scar tissue may cause retinal detachment.

Let's talk about assessment.

Babies will be assessed by a ophthalmologist who has training in retinopathy of prematurity.

The retina is divided into three zones.

Zone 1 includes the optic nerve and the macula.

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