Retinopathy of prematurity is a serious disorder associated with the disturbed development of the retina (the light sensitive section of the eye) in prematurely born children.
The first case of retinopathy in a prematurely born child was diagnosed in 1942 by the American ophthalmologist Terry who gave a description of the clinical picture and named the disorder – retrolental fibroplasia.Later, doctors established connections between the distorted growth of blood vessels and the high concentration of oxygen in the incubators for nursing newborns. Metabolism processes in the retina are conducted through respiration and not through glycolysis. This evidences that the source of energy lies in the decomposition of glucose which passes without consumption of oxygen. Under the impact of oxygen glycolisis*. Under the impact of oxygen glycolisis is suppressed resulting in damage of the retina.
Retinopathy usually develops on the fourth week of the infant’s life and the peak of the disorder falls on the eighth week. More often, retinopathy affects both eyes simultaneously. It is essential to start treatment of retinopathy as soon as possible since it is often accompanied by myopia, astigmatism, cataract, glaucoma, strabismus, and amblyopia which may lead to irreversible loss of eyesight.
Today, doctors believe that there are several factors that provoke retinopathy of prematurety, including:
- Premature delivery (26-28 weeks)
- Low mass of the prematurely born (1.4 kg and less)
- Artificial ventilation of the lungs during 3 days after birth
- Oxygen therapy during more than one month
- Alteration in the respiratory, circulatory and nervous systems
- Unstable state of the infant immediately after birth
- Heavy prenatal infections
Diagnosis of retinopathy of prematurity
It is essential to examine a prematurely born child one or two weeks after birth. From then on it is equally important to have the child examined by an ophthalmologist every week.
Children with suspected retinopathy have to undergo examination of the eye ground with the pupil dilated.
Bear in mind that in order to preserve the eyesight of a child diagnostic examination of the child’s vision is no less important than inoculations and examinations by a paediatrist on a regular basis. Your child’s future depends on the eyesight.
Treatment of retinopathy in prematurity born children
Medical statistics shows that there are quite a few cases when children with retinopathy of the first and second stages recover without any definite treatment. “Threshold” retinopathy (third stage) requires surgical intervention. Retinopathy of the fourth and fifth stages leads to total loss of the vision.
Cryoretinopexia may be used as a treatment method to prevent development of neoplasm in the blood vessels of the peripheral zone of the retina. Laser photocoagulation of the retina may also be applied as a treatment alternative.
These methods of treatment are aimed at preserving the central vision.
*Glycolysis is a fermentation process of consecutive decomposition of the glucose in the cells