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Retinopathy Of Prematurity In Infants

Retinopathy Of Prematurity In Infants

Prematurity retinopathy is closely related to premature birth and in most cases, involving children born before 30 weeks of gestation in utero. This disorder is generally mild and resolves spontaneously. However, it is necessary to have an eye examination until complete blood vessel growth.

If the disorder is severe, loss of vision in the newborn may require laser treatment, injections or surgical treatment to prevent vision loss.

In very premature infants, the development of blood vessels supplying the retina can be interrupted for a certain period of time. When growth begins again, it happens in a disorganized way. During this rapid and disorganized growth, the small vessels can bleed. 

Light therapy could help with retinopathy in premature babies. A particular molecular pathway could be subjugated to counter diseases in the eyes of premature children as discovered by a research group from the Cincinnati Children's Hospital Medical Center. The eyes of premature infants are very weak, often not fully developed and for this reason they face many diseases, including retinopathy of the premature (ROP).

This pathway is light-dependent and this, according to Richard A. Lang(author of the study) “raises the interesting possibility that we might be able to use light exposure to treat conditions such as retinopathy of prematurity after a premature baby was born or in people with myopia”.

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Retinal damage manifests itself in two phases: the first, due to an inadequate supply of oxygen (hyperoxia), leads to the arrest of normal retinal vascular development associated with microvascular degeneration. The resulting poor vascularization leads to the second phase, dominated by hypoxia (poor oxygenation) which induces a pathological retino-vitreale neovascularization. In this way tortuous and anomalous vessels develop which project into the vitreous body (normally not vascularized, therefore transparent) and attracting the retina to itself, inducing inexorable detachment.

During these two phases, “risk factors” of additional damage can occur which includes excessive fluctuations in oxygen delivered in the delivery room or during hospitalization. Also, episodes of ischemia - reperfusion (sudden drop in blood supply followed by restoration of blood flow), multiple transfusions, and infections. Most of these elements often accompany the natural clinical history of the premature newborn, especially if it is very small. As it lacks the normal defense and growth factors which in the full-term ensure optimal development.

At the moment experiments have been done on mice. In particular, the researchers showed that the post-natal eye of developing mice depends on the light responses in the retina controlled by the opsin 5, a retinal photoreceptor protein.

After genetically modifying some mice so as not to activate opsin 5, the researchers realized that without this protein the levels of dopamine in the vitreous substance of the eye increased and this hindered the normal development of the eyes.

At this point they tried to stimulate the eyes of mice with light to activate signaling with Opsin 5: this reduced the levels of dopamine in the eyes and produced molecular changes that restored normal vascular development of the eye.

Of course, further research will have to be carried out to understand if such procedures could be clinically relevant for humans.

Diagnosis

Eye exams

Retinopathy of prematurity is asymptomatic. Therefore, the diagnosis depends on careful examination. The ophthalmologist makes a regular visit to premature babies with birth weight less than 1,500 grams or born less than 30 weeks of gestation. The eye examination is repeated every 1-3 weeks until the retinal blood vessels are fully developed.

Children who develop severe retinopathy should have an eye examination at least once a year for the rest of their lives. If identified early, retinal detachment can be treated surgically in an attempt to avoid vision loss in the affected eye.

Prognosis

Children in whom prematurity retinopathy was diagnosed are at greater risk of developing myopia, strabismus and amblyopia. 

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Author Biography.

Naveed Ganatra
Naveed Ganatra

Naveed Ganatra is the professional copywriter and digital marketing strategist who writes , on subjects ranging from digital marketing to real estate niches. He has been into this industry for over 5 years and serving industry with the best of him.


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