Retinopathy of Prematurity: A Review of Risk Factors, Oxygen Targets, Screening Criteria

Abstract

Retinopathy of Prematurity (ROP) is a disease of immature retinal tissue that is strongly associated with prematurity, low birth weight, and prolonged oxygen exposure. The purpose of this review is to evaluate published literature to determine which factors can be linked to the development of ROP, which factors are protective against ROP, and which factors are still unclear. It also sought to review the major oxygenation trials in premature infants to establish the recommended oxygen saturation targets in premature babies and what criteria are useful in evaluating infants for ROP. Databases (PubMed, Medline, PubMed Central, and Google Scholar) were used to obtain relevant literary articles. Key findings suggested that major risk factors for ROP were prematurity, low birth weight, and prolonged oxygen exposure. Evidence suggests that maternal diabetes, maternal smoking, prolonged rupture of membranes, lack of antenatal steroids, ethnicity, multiple births, low Apgar scores, and sepsis are risk factors for the development of ROP. Evidence suggests that maternal hypertensive disorders, mode of birth, and chorioamionitis are not associated with ROP. Recommendations of oxygen saturations in the neonate include targets of 90-95% and 90-94%. Screening for ROP is dependent on birth weight, gestational age, and risk factors, with recommendations varying according to pediatric societies.