One of the most important health problems seen in babies who say hello to life early is retinopathy of prematurity. As birth weight and week of birth decrease, the risk of developing this disease in infants increases. There are no symptoms of the disorder that occurs in the retina layer of the eyes of preterm babies, which can cause nerve damage and cause vision loss. From Memorial Ankara Hospital Ophthalmology Department, Op. Dr. Neslihan Astam gave information about retinopathy of prematurity and its treatment process before “November 17 World Prematurity Day”.
Retinopathy of prematurity first cause of preventable blindness
Retinopathy of prematurity, which is seen in babies born before 32 weeks and with a birth weight of less than 1500 grams, is a disease that occurs in the avascular areas of the retina of the eyes of these babies and can cause nerve damage and cause vision loss. Low birth weight and high-dose oxygen therapy are the most important risk factors for retinopathy of prematurity (ROP), which is the leading cause of preventable blindness in childhood.
Health conditions affect the incidence of the disease
The equipment of the neonatal intensive care unit in the center where the baby was born is the most important factor affecting the incidence of retinopathy of prematurity. While early diagnosis and treatment of this disease is possible in developed countries, poor health conditions and lack of control in underdeveloped countries prevent the detection of the disease and cause an increase in the rate of vision loss in infants.
Asymptomatic, detected by examination
There are no symptoms related to retinopathy of prematurity, which is classified in 5 different stages from mild to severe. This disease can only be detected with the follow-up protocols to be applied to premature babies and the examination of the back of the eye (retina). Babies born under 32 weeks should have their first examination 28 days after birth. In cases where there is no risky situation for ROP as a result of the examination, the patient is followed every two weeks until the vascularization in the eye is completed. However, when a finding related to the disease is detected, the frequency of follow-up is determined as once a week or every 2-3 days, depending on the severity and stage of this finding.
The stage and severity of the disease determine the treatment.
Treatment of retinopathy of prematurity varies according to the stage and severity of the disease. In anti-VEGF injection treatment, the drug is injected into the eye at certain doses and at certain intervals. This procedure, which is performed in the operating room with the sedation method, is continued every 4-6 weeks until the progression of retinopathy of prematurity stops. In cases where anti-VEGF injection therapy is not sufficient, indirect laser photocoagulation therapy can be applied with or without injection therapy. In this procedure, photocoagulation is performed using an indirect laser ophthalmoscope on the avascular areas of the retina under light sedation. If the progression continues despite these treatments, then surgical treatment may be required. Vitreoretinal surgical treatment is applied to patients who develop retinal detachment and intraocular bleeding.
Untreated ROP causes blindness
There is no spontaneous regression of this disease in patients with ROP. Early diagnosis of this disease is of great importance. Early diagnosis plays a major role in children's lives, as it can cause irreversible vision damage. The earlier the diagnosis is made, the earlier the stage and severity of the disease are detected, the less loss of vision and the higher the chance of treatment. The condition of untreated retinopathy of prematurity patients results in blindness. For this reason, every baby born prematurely should have an eye examination.