Retinopathy of prematurity is a disease of the eye, due to impaired retinal development in premature babies. The disease is considered dangerous because it can result in a complete loss of vision.
Modern medicine has all the possibilities for nursing newborns in which the mass is at the level of five hundred grams, but every fifth premature baby suffers retinopathy of prematurity, with 8% of them sick in severe form.
Causes of retinopathy
Relatively recently it was believed that the retinopathy of prematurity is provoked by an exceptionally high concentration of oxygen in the incubators. After that, the oxygen content was limited, which reduced the incidence of the disease, but increased the death rate from respiratory distress syndrome, in addition, the number of severe complications of hypoxia in surviving infants increased.
It has now been found that retinopathy of prematurity can develop under the influence of many factors. At risk, preterm infants who have a birth weight less than two thousand grams and a gestation period of up to thirty-four weeks. The risk of retinopathy increases significantly when more than three days of mechanical ventilation and more than a month of oxygen therapy are performed.
In addition, there are additional risk factors, such as severe intrauterine infections, cerebral hemorrhages, hypoxia (ischemia) of the brain, provoked by complications of pregnancy and childbirth.
A very important factor that can influence the development of LV is considered light exposure to the ripe retina, because in the natural conditions, retinal vessels complete their formation in utero, that is, in the absence of light. To a premature baby, excess illumination reigns.
They also say about the genetic predisposition to the disease.
Symptoms of retinopathy of prematurity
The basis of this disease is the incompleteness of the formation of the eyeball, retina and vascular system. The formation of retinal vessels begins on the sixteenth week, this occurs from the center of the optic nerve to the periphery, and ends with the birth of a full-term baby. That is, the earlier a child was born, the area of the retina covered with blood vessels is smaller, and the avascular zones are excessively extensive. In a seven-month fetus, concentric underdevelopment of the retina is observed, when the central part is supplied with blood, but there are no blood vessels on the periphery. When a premature baby is born, various factors influence the process of its formation: the external environment, oxygen, light, which in a complex and stimulates the development of retinopathy.
The main pathological manifestation of retinopathy of prematurity is the cessation of normal vascular formation, when they begin to germinate into the eye in the vitreous body. Further, a new formation of connective tissue behind the lens, causing tension and leading to detachment of the retina.
How to treat retinopathy?
Treatment of the third stage of retinopathy is carried out with the help of a laser or cryocoagulation of the avascular zone of the retina, but the intervention should be carried out not later than three days after the moment of its detection. At later stages, surgical treatment is resorted to, transciliary vitrectomy and circular scleral filling are performed.
Cryocoagulation is performed mainly under anesthesia, under local anesthesia it is done less often. This freezes the avascular part of the retina, stops the development of scar tissue and stops the pathological process. Most of the ophthalmologists presently prefer to produce laser coagulation of the avascular retina, which is associated with its less traumatism and the number of adverse reactions, more effective, the procedure allows for more precise control of the intervention process.