早產嬰兒視網膜病變(ROP)
早產兒視網膜病變（ROP）是指位於眼睛底部的視網膜出現血管異常增生的情況。嬰兒出生的週數愈早、出生的體重愈輕、以及在出生早期的病情愈為反覆（例如：低血壓，呼吸不穩），患上早產兒視網膜病變的風險就愈高。[1] 研究發現，餵哺母乳是預防早產兒視網膜病變的方法之一。[2]
早產兒視網膜病變約在受孕後34週出現。嬰兒一般不會出現任何症狀，需透過眼科醫生為他們定期進行篩查而作出診斷。患有此病的嬰兒需定期接受眼睛檢查以跟進病情，直至完全康復。嚴重的早產兒視網膜病變可能導致視網膜出血甚至視網膜脫落，影響嬰兒將來的視力發展。
大多數患者會隨著時間自然康復，無需接受任何治療。然而，情況嚴重的患者需接受激光治療來消除視網膜中異常的血管。[3] 眼科醫生會根據嬰兒的病情來決定激光治療的時間和次數。
Retinopathy of prematurity (ROP)
Retinopathy of prematurity (ROP) is an eye condition that occurs in the retina of preterm babies. It is due to abnormal blood vessel growth developing over the retina, which is located on the inner surface of the back of the eye. The risk of ROP is higher in babies who are born extremely preterm, with lower birth weight and those who experienced more stressful events during early life, e.g., hypotension, poor respiratory condition.[1] The abnormal growth of blood vessels often happens following these insults which disrupt normal blood vessels development. Breastfeeding is found to be a factor that prevents ROP.[2]
ROP presents approximately at post-conceptional age of 34 weeks. Babies generally do not develop any symptoms and ROP is diagnosed through regular screening by ophthalmologists. Follow-up examination needs to be performed regularly to monitor the progress of ROP until it is resolved. Severe ROP could cause bleeding or even detachment of the retina, which greatly affects how well the baby sees in the future.
The majority of babies with ROP recover spontaneously with time without any treatment. However, those with severe disease will require laser therapy to destroy the extra abnormal blood vessels in the retina.[3] The timing and number of laser therapy sessions will need to be decided by ophthalmologists depending on baby’s condition.
Written by Dr. Sharon Lau
Resident, Department of Paediatrics
Prince of Wales Hospital
Reference:
[1] Lad EM, Hernandez-Boussard T, Morton JM, Moshfeghi DM. Incidence of retinopathy of prematurity in the United States: 1997 through 2005. Am J Ophthalmol 2009; 148:451.
[2] Bharwani SK, Green BF, Pezzullo JC, et al. Systematic review and meta-analysis of human milk intake and retinopathy of prematurity: a significant update. J Perinatol 2016; 36:913.
[3] Emami S. Laser Treatment for Retinopathy of Prematurity: A Decade since ETROP. Journal of the American Academy of Ophthalmology 126.4 (2019): 639-641.