Restricting supplemental oxygen use reduces the rate of ROP, but may raise the risk of other hypoxia-related systemic complications, including death.Patients with ROP, particularly those who have developed severe disease needing treatment are at greater risk for strabismus, glaucoma, cataracts and shortsightedness (myopia) later in life and should be examined yearly to help prevent or detect and treat these conditions. Diagnosis
The stages of ROP disease have been defined by the International Classification of Retinopathy of Prematurity (ICROP). In older patients, the appearance of the disease is less well described but includes the residua of the ICROP stages as well as secondary retinal responses. International classification
The system used for describing the findings of active ROP is entitled The International Classification of Retinopathy of Prematurity (ICROP). ICROP uses a number of parameters to describe the disease. They are location (zone) of the disease, the circumferential extent of the disease based on the clock hours, the severity (stage) of the disease and the presence or absence of "Plus Disease". Each aspect of the classification has a technical definition. This classification was used for the major clinical trials. It was revised in 2005. The zones are centered on the optic nerve. Zone I is the posterior zone of the retina, defined as the circle with a radius extending from the optic nerve to double the distance to the macula.
Secondary airway malacia was defined as airway malacia secondary to esophageal atresia, VATER/VACTERL association (condition with vertebral anomalies, anal atresia, congenital heart disease, tracheoesophageal fistula or esophageal atresia, renourinary anomalies, or radial limb defects), vascular or other external compression of the airways, or specific syndromes. Treatment
Time
Minimally Invasive, usually in conjunction with Continuous Positive Airflow Pressure. Continuous Positive Airflow Pressure
A method of respiratory ventilation. Tracheotomy
Surgical procedures on the neck to open a direct airway through an incision in the trachea (the windpipe). Prosthesis
Insertion of a prosthesis to keep the bronchial tube open. Notes
References
Carden, KA, Boiselle, PM, Waltz, DA, et al. (2005) Tracheomalacia and tracheobronchomalacia in children and adults: an in-depth review. Chest 127,984-1005. Clements, B Congenital malformations of the lungs and airways. Taussig, LM Landau, LI eds. Pediatric respiratory medicine 1999,1106-1136 Mosby. St. Louis, MO
Austin, J, Ali, T Tracheomalacia and Bronchomalacia in children: pathophysiology, assessment, treatment and anaesthesia management. Paediatr Anaesth 2003;13,3-11
McNamara, VM, Crabbe, DC Tracheomalacia. Paediatr Respir Rev 2004;5,147-154
Benjamin, B Tracheomalacia in infants and children. Ann Otol Rhinol Laryngol 1984;93,438-442


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