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ROPARD Online Education Section Module 4
Module 4 –
Management of Stage 5 Retinopathy of Prematurity
Unfortunately, some
children will achieve stage 5 retinopathy, most likely due to
inappropriate screening or perhaps a genetic predisposition.
Certainly in some ethnic groups, a more aggressive form of
neovascularization exists leading to large amounts of blood in the
subretinal space as well as tractional retinal detachments.
These eyes require different surgical intervention. If the
eye has achieved any peripheral ablation, the anatomic results
following lensectomy, vitrectomy, and membrane peeling, again
performed in a two-port fashion, can result in a 76% anatomic
reattachment of at least the posterior pole and visual acuities
ranging from 20/60 to no light perception as outlined in the
module. These visual results yield 28% of eyes that have no
light perception, 72% that have 20/60 vision to light perception,
48% 20/60 to 20/1900 vision, 30% 20/60 to 20/800 vision, and 15%
20/60 to 20/300 vision. These visions, although not as good
as we would like them to be, are certainly better than the no
light perception that is mandated by the natural history of the
disease. With appropriate screening, peripheral ablation,
and management of 4A retinopathy of prematurity, many less stage 5
eyes will appear.
In summary, with
appropriate screening and management of the retinal vascular
disease and retinal detachment, good anatomic and visual results
can be achieved.
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Congratulations, you have completed the course
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