Retinopathy of Prematurity
With today’s technology, babies being born very early could be kept alive thanks to the neonatal care units. However in post natal period, ophthalmic development is specifically different from the other tissues and organs. The last 12 weeks of pregnancy is a period when retinal layer’s and vessels’ development gets faster. In premature babies retina and vessels remain shorter therefore they can not reach to the point where they should extend.
In the picture’s upper half one can see the healthy retinal vessels, and in the lower half the empty region where there is the lack of vascularity.
When the baby is born new, unusual vessels emerge by these undeveloped vessels. These new vessel formations are vulnerable against hemorrhage and the complication called retinal detachment.
In newborn retinopathy the unhealthy vessels lead intraocular hemorrhage, retinal break and retinal wrinkles.
The risk of premature retinopathy is especially high for the premature babies who are under 32 weeks, 1500 grams, and who had an intense oxygenotherapy in an incubator environment, intracranial hemorrhage, infection, and anemia.
The babies who comply with one or several criterias mentioned above should certainly have a detailed retinal examination. This retinal examination should, by all means, at the latest, be made between the 4th and 6th weeks after birth.
In premature retinopathy the detailed retinal examination is made with the indirect ophthalmocopy method.
In these examinations if your doctor determines a progression in the disease he/she can recommend treatment. In premature retinopathy the treatment is made by laser. The purpose, is to prevent the development of complications mentioned above such as hemorrhage and detachment in new vessel formations.
When the laser treatment is ineffective, or the treatment is run late, there may be a necessity of vitrectomy surgery for intraocular hemorrhage and retinal detachment.
To avoid the need of surgery in premature retinopathy, the premature babies should get under a retinal examination and the required tracking should be made.
Kids who had a story of premature retinopathy are more likely in need of using glasses in early ages compared with their peers. Therefore their visual inspections should be made after the age 2 or 3. For the adults having a story of premature retinopathy, the risk of retinal detachment is higher than the usual. Therefore their annual examinations should not be avoided.