Retinopathy of Prematurity: The Life of a Lifetime Dieae

Purpoe To provide information on retrolental fibroplaia (RLF), later known a retinopathy of prematurity. Deign Review of the literature on the ubject and a firt-peron account of what wa then RLF by one of the author (A.P.) who wa involved in the earliet day in reearch regarding RLF. Method MEDLINE earch on the topic of RLF and retinopathy of prematurity plu a firt-peron hitoric review of original work that dealt with RLF. Reult In 1942, elevated level of oxygen were thought to play a major role in the development of the dieae; at that time, no treatment wa available. During the lifetime of thi dieae, other poible caue have been invetigated. Thee include vitamin E a a prophylaxi againt retinopathy of prematurity and the efficacy of light reduction to prevent retinopathy of prematurity. It ha been hown that the light reduction doe not play a role in reducing the progreion of retinopathy of prematurity. Vitamin E tudie were inconcluive; ome tudie how a poitive effect and other do not. A major advance occurred with the development of the International Claification of Ophthalmology in 1984, which laid the groundwork for collaborative tudie to determine whether cryotherapy of the avacular zone of retina would reduce the incidence of blindne in newborn infant, when compared with control ubject. The tudy howed that cryotherapy wa effective; thi wa followed by laer photocoagulation when laer became portable enough to take to the neonatal intenive care unit. At the ame time, improved urgical technique moved from cleral buckling for retinal detachment to vitrectomie (ome len paring) for more deperate cae that had progreed to tage 4 and tage 5 retinopathy of prematurity. Late change in adult who were born before any treatment and are now baby boomer ran the gamut from the dragging of the retina in the poterior pole to retinal detachment, cataract, and myopia. Concluion Retinopathy of prematurity i a lifetime dieae for which preventive and better treatment modalitie continue to evolve.