Nowadays, with the developing technology, thanks to neonatal care units, babies with smaller birth weights and premature babies can be kept alive. However, the development of the eye, especially in the postnatal period, differs from other tissues and organs. The last 12 weeks of pregnancy are an important period in which the development of the retina and vessels of the eye accelerates. In premature babies, the retina and vessels remain shorter than the area they should reach and cannot develop. When the baby is born, abnormal new vascular formations emerge from these underdeveloped vessels. These new vascular formations are prone to bleeding and complications called retinal detachment.
In neonatal retinopathy, diseased vessels cause bleeding into the eye, retinal tears, and retinal shrinkage. The risk of developing premature retinopathy is especially high in premature babies who are younger than 32 weeks, have a birth weight below 1500 grams, have received intensive oxygen therapy in an incubator environment, have had respiratory problems, have had intracranial bleeding, have had an infection, or have anemia. Babies who meet one or more of the above criteria must undergo a detailed retinal examination. This retinal examination must be performed between the 4th week and the 6th week at the latest after birth. In neonatal retinopathy, a detailed retinal examination should be performed by indirect ophthalmoscopy method.
During these examinations, if your doctor sees a progression in the disease, he may recommend treatment. Treatment of premature retinopathy is done with laser. The aim is to prevent the development of complications such as bleeding and detachment mentioned above due to new vascular formation. In cases where laser treatment is ineffective or treatment is delayed, vitrectomy surgery may be required for eye bleeding and retinal detachment. In order to avoid the need for surgery in premature retinopathy, premature babies must undergo a timely retinal examination and necessary follow-ups.
The need to wear glasses at an early age is higher in children with a history of retinopathy of prematurity than their peers. That’s why eyeglasses should be checked starting from the age of 2-3. Adults with a history of retinopathy of prematurity also have a higher than normal risk of developing retinal detachment. That’s why annual checks are necessary.
Prof. Dr. Tansu Erakgün
Retina Diseases and Vitreoretinal Surgery Specialist
Born on March 20, 1968, in İzmir, Prof. Dr. Tansu Erakgün completed his middle education at Saint Joseph College and his high school education at Karşıyaka Gazi High School. After graduating from Ege University Faculty of Medicine in 1992, which he entered in 1986, he began his residency training in the Department of Ophthalmology at Ege University Faculty of Medicine Hospital in the same year. In 1997, he became a specialist...
About Me VideosHow is premature retinopathy treated?
There are various points on how to treat premature retinopathy, which is an important treatment. Retinopathy of prematurity is an eye disease seen in babies born prematurely and can lead to serious vision loss if left untreated. Hospitals in Izmir have the necessary equipment and expertise for the treatment of premature retinopathy. Neonatal Retinopathy Treatment is generally applied by three methods in big cities like Izmir; laser treatment, needle treatment and surgical treatment. Laser therapy and needle therapy are used to dry abnormal vessels in the eye. Surgical treatment is an operation to eliminate abnormal vessels and tissues.
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Laser treatment is usually performed under local anesthesia and a laser imaging device called indirect laser ophthalmoscope is used during the procedure. Abnormal vessels are treated with laser, preventing bleeding and other serious complications. In needle therapy, a substance that narrows and eliminates unwanted vessels is injected into the eye. Surgical treatment is usually performed under general anesthesia and abnormal vessels are removed during the surgery. This method can be applied to babies who do not respond to laser treatment or have advanced retinopathy.
During the treatment process, the eye health of babies is closely monitored. Babies’ eyes are examined at regular intervals and the effect of the treatment is checked. As a result, treatment for retinopathy of prematurity can prevent serious vision loss when applied at the right time and in the right way. Eye health of babies can be protected with treatments performed by specialist doctors in hospitals in Izmir.
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F.A.Q.
What are the stages of neonatal retinopathy?
Pre-plus phase: In this phase, changes are seen in the retina layer, but there is no vision loss. Plus phase: In this phase, more serious changes are seen in the retina layer and vision loss begins to occur. Intraocular proliferative phase: In this phase, serious changes in the retina layer occur. Changes occur and vision loss progresses further. In this phase, the formation and growth of blood vessels within the eye can be seen. Full proliferative phase: In this phase, serious changes occur in the retina layer and vision loss progresses further. In this phase, the formation of large amounts of blood vessels in the eye and its growth can be seen.
Until what age does neonatal retinopathy occur?
Neonatal retinopathy usually occurs in the first few weeks of the baby’s birth and is usually detected during this period. If neonatal retinopathy is detected within the first few weeks of the baby’s birth, it can be treated and vision loss can be prevented. However, “If the detection of neonatal retinopathy is delayed, the treatment effect may decrease and vision loss may progress further. Therefore, it is important to examine the baby’s eyes in the first few weeks immediately after birth.
What causes neonatal retinopathy?
Neonatal retinopathy is a disease that occurs as a result of the incomplete development of the retina (network layer) and vessels in the eye in premature babies. Neonatal retinopathy usually occurs within a few weeks after birth and the baby is usually born prematurely (before 32 weeks). “However, there are other variable factors that can cause this condition. Neonatal retinopathy can lead to complete blindness if left untreated.
References:
https://kidshealth.org/en/parents/rop.html
Holmström, G., Broberger, U., & Thomassen, P. (1998). Neonatal risk factors for retinopathy of prematurity‐a population‐based study. Acta Ophthalmologica Scandinavica, 76(2), 204-207.