Screening for Retinopathy of Premature Infants
Release time : 06/07/2025 09:30:01
For families of premature babies, it is important to pay attention to the physical indicators of premature babies 'survival. Parents of premature babies weighing less than two kilograms should promptly take their children for prematurity retinopathy screening to prevent blindness due to childhood retinopathy.
Premature infants have not yet developed the blood vessels of the visual network, and are prone to retinal neovascularization and fibrous hyperplasia, most of which occur in both eyes. The mild cases can heal themselves, while the severe cases can lead to blindness due to diseases such as retinal detachment. However, with the advancement of screening technology for retinopathy of prematurity, babies can be cured as long as they can receive early treatment.
There are many causes of retinopathy of prematurity, most of which are related to factors such as oxygen therapy, maternal anemia, and multiple fetuses. Retinopathy of prematurity can be cured if it is detected early and treated early. Once the best treatment opportunity is missed, the baby may eventually lose his vision.
What does the screening for retinopathy of prematurity entail? It involves conducting a screening for retinal lesions in premature infants and low birth weight infants, starting from 4-6 weeks after birth or when the gestational age is 32 weeks corrected. Fundus examination is an effective means to detect retinal lesions in these infants early on.
The incidence of retinopathy of prematurity is on the rise year by year. Retinopathy of prematurity, which occurs in premature infants' eyes, includes retinal degeneration, retinal detachment, secondary cataract, and secondary glaucoma, etc. In severe cases, it can lead to blindness.
Timely screening for retinopathy in preterm infants can effectively prevent the occurrence of this condition. Even if it occurs, early detection and treatment can still lead to recovery.
In cases of prematurity retinopathy stage 1-2, only periodic follow-up is required; stage 3 is the optimal treatment period and can be cured by laser therapy.
If the condition is missed in three sessions, it can develop to an advanced stage within 1-2 weeks. Therefore, the treatment window is typically only a few short weeks. However, in premature infants, retinopathy of prematurity stages 1-3 do not present any abnormalities at first sight. If parents notice any abnormal appearance in their child's eyes, it is often already late, and often leads to blindness.
To ensure the health of your baby, mothers should take their babies to the hospital for a premature infant retinopathy screening as soon as possible.
How to screen premature infants' retinopathy? With the progress of neonatal medicine diagnosis and treatment level in our country, the survival rate of low-gestational age and low-birth weight premature infants has been gradually improved. Premature infants' retinopathy has become one of the main reasons that threaten the eyesight of premature infants and even cause blindness.
Preterm infants have incompletely developed retinal vessels, which can lead to the formation of neovascularization and fibrosis in the retina. This condition is commonly observed in both eyes. In mild cases, it may resolve spontaneously, but in severe cases, it can result in retinal detachment and other complications leading to blindness.
However, with the advancement of screening technology for retinopathy of prematurity, if early treatment is obtained, it can be cured. So, how to conduct a retinopathy of prematurity screening? The first fundus examination should generally be conducted between 4~6 weeks after birth or at 32 weeks of gestational age, and subsequent follow-up examinations should be determined based on the results of the first examination.
If there are no pathological changes in both eyes, or if only the first stage of changes is present, a follow-up examination every week can be performed until the retinal vessels have reached the slit-like edge.
If there are two stages of disease, it should be checked once a week; during the follow-up process, if the disease improves, it can be checked every two weeks until the disease completely disappears.
Should there be 3-stage lesions, it is recommended to perform weekly follow-up examinations at intervals of 2 to 3 times.
If the threshold level is reached, cryotherapy or laser treatment should be performed within 72 hours after diagnosis. Mothers should pay attention to the treatment of retinopathy of preterm infants in a timely manner to minimize the damage to the vision of premature infants.
Symptoms of Retinopathy of Prematurity in Infants. The optimal time for treatment of ROP is from the 4th to 6th week of life. If treated within this period, the eyesight of the child will be normal. However, the treatment only lasts for two weeks, hence it's also known as the "window of time". If the window closes after this period, only 10% of treatment possibilities remain. Once the window of time is closed, the child will fall into a perpetual darkness.
Let's take a moment to explore the symptoms of retinopathy of prematurity in premature infants.
1. Vascular alteration phase: This is the initial stage of the disease, characterized by tortuous dilation of both arteries and veins. The diameter of the veins sometimes exceeds that of normal by 3 to 4 times, with capillary pedicles in the peripheral retina appearing like brush-like structures.
2. Retinal Stage: As the condition progresses, the vitreous becomes cloudy and the retina appears hazy. New vessels on the retina proliferate, mostly located near the equatorial region, but also present in the anterior or posterior pole regions. The retina of this area is significantly elevated with blood vessels crawling over its surface, often accompanied by varying degrees of retinal hemorrhage.
3. Early Proliferative Stage: The aforementioned localized retinal protrusions exhibit proliferating blood vessels, which extend into the vitreous cavity, leading to the development of small areas of retinal detachment at the peripheral (mostly) or posterior pole (rarely) of the fundus.
4. Moderate proliferative stage: The area of detachment has expanded to more than half of the retina.
5. Extreme Proliferation Stage: Total retinal detachment.
At times, a large amount of blood can also be observed within the glass chamber.
What causes retinopathy of prematurity? Retinopathy of prematurity is a proliferative retinopathy in premature or low birth weight infants. The condition, if mild, may leave no traces and does not affect vision, but in severe cases, both eyes may be irreversibly affected by proliferation until complete blindness occurs.
The rate of retinopathy in preterm infants is approximately 15-30%, with almost all patients being preterm low birth weight infants.
What are the causes of premature retinopathy in infants? 1. Generally, there is a history of excessive oxygen exposure during the neonatal period within a warm incubator, with the incidence increasing with the duration of oxygen exposure. There is also a risk for this condition in infants without an oxygen exposure history, which can be attributed to rapid increases in fetal hemoglobin oxygen saturation and the transition from fetal to neonatal oxygen partial pressure.
Additionally, maternal anemia and the presence of multiple fetuses are also factors that contribute to retinopathy of prematurity.
2. In the early stage of the fetus, the retina develops, the vitreous arteries and choroid provide nutrition. When the embryo is 100mm, the vitreous blood vessels pass through the optic disc, and at the same time, there are small branches extending from the optic disc to the surrounding retina.
Initially, they are only observed in the nerve fiber layer and not until the late stage. In normal fetuses at 6-7 months of gestation, there is significant vascular proliferation; premature infants have not yet fully developed their retinas and the peripheral parts are the least mature.
3. Under conditions of high oxygen levels, retinal blood vessels constrict and obstruct, leading to local ischemia and hypoxia, thereby triggering abnormal proliferation of retinal capillaries, resulting in a series of changes such as exudation, hemorrhage, and sclerosis.
Abnormal proliferation of retinal blood vessels penetrates the internal limiting membrane and extends towards the surface of the retina. With effusion into the vitreous, these vessels undergo fibrosis, forming a connective tissue membrane behind the lens, which can also cause retinal detachment.
How to Prevent Premature Rupture of Retinal Vessel? The premature rupture of retinal vessel is a kind of disease caused by abnormal proliferation of the retina's blood vessels in newborns, and related to oxygen treatment, maternal anemia and polyhydramnios.
Although there has been some understanding of the disease, many parents and even non-specialized doctors still lack an adequate understanding of it. As a result, many premature infants miss their optimal treatment window due to insufficient examination time.
So, how to prevent retinopathy of prematurity? The only effective prevention is the restriction of oxygen for premature infants. Except for the cases with severe cyanosis and life-threatening situations, the concentration of oxygen should be 40% and the duration should not be too long.
Furthermore, the early and high-dose administration of vitamins may also play a certain preventive role. Timely detection and implementation of cryotherapy or laser photocoagulation have been reported to successfully stop the further deterioration of lesions.
Additionally, to prevent the occurrence of secondary glaucoma in premature infants with retinopathy of prematurity, it is imperative to frequently dilate them during active phases to avoid posterior synechiae formation.
In summary, the complications of retinopathy of prematurity must also be given due attention and proactive measures should be taken for prevention and treatment.
The medical information provided in this text is for reference only.
In case of discomfort, it is recommended to seek medical attention immediately for accurate diagnosis and treatment.