angles of the lateral ventricles. Associated with PVL is corresponding cortical volume
loss overlying these areas.
Two types of PVL are encountered.
Cystic PVL is found in 5% of all VLBW infants. It is characterized by focal cystic
necrotic lesions deep in the cerebral white matter. These may be seen at any time after
birth, but generally appear between 2 and 4 weeks. May be seen on head ultrasound.
Diffuse PVL is the most common cause of brain injury in preterm infants. It is the
major cause of cognitive defects and impaired neurodevelopment in this population.
MRI is the preferred modality for diagnosis.
There is increasing evidence that the presence of PVL correlates more strongly to
cerebral palsy (CP) than any of the grades of IVH. Also, there are trends in the
literature suggesting that the highest predictors of PVL are the presence of intrauterine
infections, hypoxia, or ischemia. Screening for PVL in the NICU is accomplished by
head ultrasound performed at 1 month of life or later. PVL is a lesion that appears 2- 3
weeks following the inciting insult.
VII. RETINOPATHY OF PREMATURITY (ROP)
Retinopathy of prematurity is a disorder of vascular and retinal development in preterm
infants resulting from prematurity and oxygen use. In severe forms, retinal scarring,
traction folds, and detachments can lead to blindness. Screening for ROP should meet
the Joint Statement by the AAP, AAO and AAPOS (Pediatrics 117(2):572, 2006).