A baby is born prematurely at 28 weeks gestational age with a bihweight of 1200 g. Ventilation with high paial pressures of oxygen is staed, but the neonatologist is concerned about the possible development of retinopathy of prematurity (formerly called retrolental fibroplasia). What is the underlying mechanism by which this retinal lesion may develop?

The underlying lesion in retinopathy of prematurity (retrolental fibroplasia) is an inappropriate proliferation of vessels in the inner layers of the retina. If the process is disrupted early, the retina may heal with little residual damage. However, persistence of the process predisposes for permanent damage due to exudation, hemorrhage, and secondary detachment of the retina. Ganglion cell and optic nerve degeneration are features of retinal damage due to glaucoma. Pigment deposition in the retina is unrelated to retinopathy of prematurity. Ref: Fletcher E.C., Chong N., Augsburger J.J., Correa Z.M. (2011). Chapter 10. Retina. In P. Riordan-Eva, E.T. Cunningham, Jr. (Eds), Vaughan & Asbury's General Ophthalmology, 18e.