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Lifetime implications of ROP suggest a looming crisis for ophthalmology, speaker says
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CHICAGO — Although significant achievements have been made in the recognition and treatment of retinopathy of prematurity, the disease remains a prevalent challenge to ophthalmologists.
Chief among the effects of ROP disease, William S. Tasman, MD, FACS, said during the 2010 Schepens Lecture during the Retina Subspecialty Day prior to the joint meeting of the American Academy of Ophthalmology and the Middle East Africa Council of Ophthalmology, are the lifetime sequelae of patients who had ROP in infancy.
For instance, Dr. Tasman said, adults with history of ROP have a high rate of myopia; however, these patients appear to have myopia secondary to steeper corneas rather than elongated axial length, Dr. Tasman said.
As well, adults after infant ROP appear to have earlier onset of cataract, notably nuclear cataracts. A sampling of 24 adults with history of ROP performed by Dr. Tasman found an average age of 44 years for onset of cataract. Yet, even young infants appear to be at greater risk for cataract formation.
"They have a tendency for their capsules to opacify as early as 4 weeks," Dr. Tasman said.
The appearance of these lifetime consequences may reflect the improvements in care of premature infants, which has allowed a greater number of preemies to survive into adulthood. As these better standards of care continue to expand globally, it is likely that ophthalmology will continue to see more and more patients with these, and other, long-term sequelae, Dr. Tasman said.
This is a very interesting study that comments on the fact that patients with ROP have a higher incidence of cataracts at a younger age than the average population. This means that these patients will need to be followed closely throughout their childhood and young adulthood. Also, upon approaching these ROP patients, one must keep in mind that the anatomy of the eye may be different, such as steeper corneas or abnormal retinas, and as such, cataract surgery and IOL choice must be specific to each of the needs of these patients. Cataract surgeons must work in conjunction with retinal specialists to optimize the outcomes of these patients.
– Rosa Braga-Mele, MD, MEd, FRCSC
OSN
Cataract Surgery Section Editor