What is the reason for retinal screening in premature babies?

1. Why is fundus screening important for premature infants?

Because most of the optic nerve network blood vessels of premature infants are not fully developed, they are prone to retinal neovascular fibroplasia, and in severe cases, the retina will lose vision due to retinal detachment, especially after birth, there are premature infants who absorb oxygen, and the probability of retinopathy is higher, and because retinopathy cannot be seen from children's eyes in the early stage, it is easy to be ignored, so fundus screening after birth is essential.

2. The necessity of fundus screening in preterm infants.

In the daily physical examination, we can regularly re-examine the eyes according to the advice of the ophthalmologist, so as to achieve early detection, early diagnosis, and early **. Fundus screening can help in the early detection of blinding eye diseases (e.g., retinopathy of prematurity, retinoblastoma, fundus hemorrhage, coats disease, etc.). As well as early guidance and **.

Of course, the methods of eye disease screening include not only fundus screening, but also pupil response to light, red light reflex, slit lamp, diopter and other tests.

3. The harm of retinopathy of prematurity.

The blood vessels in the baby's eye begin to develop around 16 weeks of pregnancy, and by around 34 weeks of pregnancy, the blood vessels in the eye have developed enough to supply the retina with good blood**. The younger the gestational age of a preterm infant, the less fully developed retinal blood vessels become. However, premature infants have immature ocular blood vessels and are susceptible to neonatal asphyxia, oxygen inhalation, infection, patent ductus arteriosus, blood transfusion, hormone application and other factors, resulting in abnormal growth.

Retinopathy of prematurity is an abnormal condition that occurs in the retina of low weight premature infants and can lead to traction retinal detachment or even severe visual impairment or blindness in newborns.

Fourth, the first period of fundus screening for premature infants.

Ophthalmologists remind that if there are premature babies in the family, low birth weight infants, or children who receive oxygen for a long time after birth, they should take retinal screening in time. In general, retinal screening should be started at 4 to 6 weeks or 31 to 32 weeks gestational age in preterm infants born at less than 31 to 32 weeks' gestational age, while preterm infants born at more than 32 weeks' gestational age can be screened after birth.

Premature babies are not well developed and have poor body resistance, so they are more prone to retinopathy for the eyes, so they will do fundus examination, so that they can be found in time, and if there are symptoms, the right measures can be taken.

Because this can check whether there are some abnormalities in the body of the premature baby, and the body of the premature baby is very weak, the resistance is also very weak, the immunity is also very weak, and the premature baby is very easy to get sick, so the premature baby should be screened for retina.

Because the functions of premature babies are weaker than those of normal babies, they are afraid that the development of various organs will be affected, so they do retinal screening, and they are afraid that their vision will be affected or their retina will be damaged.

If a premature baby is unfortunately diagnosed with retinopathy, what should I do?

Retinopathy of prematurity refers to a disease caused by vasoconstriction and vascular proliferation of oxygen in the incomplete vascularized retina. The severity of the lesion is different, and the regimen is also different, and for the early lesions, there is usually no need to treat, and regular follow-up is sufficient; For moderate lesions, retinal photocoagulation or condensation is generally performed according to the degree of lesions**; If there is retinal detachment, retinal proliferation, or macular lesions, vitrectomy is required.

Retinopathy of prematurity requires an individualized approach based on the stage of the lesion. For prethreshold lesions and children who do not develop retinal detachment, anti-VEGF** or laser** can be used, most of which can stop the progression of the disease; Children who have already developed retinal detachment may need to undergo episcleral compression, vitrectomy, or lens resection, depending on the condition.

Good antenatal care reduces the risk of retinopathy of prematurity. If you are born preterm and have abnormal breathing, oxygen should be carefully monitored to avoid oxygen saturation. Preterm infants should have their eyes thoroughly examined about 6 weeks after birth, and then every few weeks until the retinal blood vessels are fully developed.

Mild retinopathy of prematurity resolves on its own, but doctors should continue to monitor the baby's eyes. Even if retinopathy of prematurity has recovered on its own, it is susceptible to myopia, strabismus, and amblyopia. Children with severe cases are susceptible to retinal detachment.

For severe retinopathy of prematurity, cryolysis** – freezing the surrounding part of the retina – can reduce retinal detachment and blindness.

Retinopathy of prematurity, abbreviated as ROP, is common in preterm infants and occurs at up to 34 to 40 weeks' corrected gestational age. If gestational age is less than 34 weeks and weighs less than two kilograms, fundus screening of the retina is routinely performed and retinopathy develops, depending on the stage**.

The first stage of the disease usually occurs at 34 weeks, the second stage at 35 weeks, and the third stage at 36 weeks, and does not exceed 40 weeks of corrected gestational age, and the most serious is a detachment of the retina.

The most common way is through ophthalmology, and the most common method is laser. Drugs**, including local injections of monoclonal antibodies with bevacizumab**, as well as scleral surgery and vitrectomy to improve retinal lesions.

Whether it is necessary and which method to use** needs to be determined according to the stage of corrected gestational age of preterm infants, how many weeks of corrected gestational age, and the degree of fundus lesions are staged. **Mainly by ophthalmology**, pediatricians should have a history of premature infants, that is, a gestational age of less than 34 weeks, a birth weight of less than two kilograms, and a history of oxygen inhalation, or the mother has a history of hyperglycemia during pregnancy, etc., in the case of adverse high-risk factors, it is recommended to carry out a screening of retinopathy in an early stage, and timely ophthalmic consultation, then a retinopathy of prematurity should be evaluated by multidisciplinary evaluation, and then a reasonable method should be adopted to avoid a bad prognosis.

It should be well healed. Because if you heal it in the early days, it is possible to be cured. If left untreated, it may worsen later.

If you have this disease, you must go to the hospital for some eye examinations, and cooperate with the doctor's way to improve the child's vision.

If this disease occurs, it is necessary to pay attention to observation and often go back for re-examination, because the premature baby is in poor physical condition and cannot be operated on, so the specific plan should be evaluated by a professional doctor before proceeding.

Hello, the symptoms of retinopathy of prematurity are:

Visual field defects, signs of bleeding in the omentum, and blood stains on the vitreous humor can cause cataracts and blindness in severe cases.

In general, retinopathy of prematurity is caused by: The premature baby is underweight. Pregnancy is too short. Pregnant women in the third trimester are exposed to high concentrations of oxygen.

If the diagnosis is a degree of retinopathy, you can not do special treatment, only need to take the baby for regular reexamination, if the diagnosis is retinopathy above the degree, you need to undergo surgery, remove the value-added fibrovascular tissue, and cooperate with photocoagulation** to save premature vision.

Why do premature babies need fundus examinations? See what ophthalmologists have to say.

The health of premature babies is somewhat worse than that of full-term babies, so a variety of tests are done after birth. Every premature baby needs to undergo fundus examination after birth, said Ding Xiaoyan, head of the Zhongshan Orthopedic Management Center of Guangdong Medical College, in an interview with a family doctor expert. Because the eye blood vessels can not grow and develop completely until term, the eye blood vessels of babies born before term have not completely grown and developed, and the baby premature baby responds to the fact that the nutrients given in the inhaled air in the stomach are completely different, so too early changes will cause the change of the eyes.

What is retinopathy of prematurity? There is a high probability that retinopathy will develop in the early stages. The person in charge of Ding Xiaoyan emphasized that because the macular blood vessels in the fundus have not grown and developed completely, the blood vessels in the eyes will become diseased, and there will be retinopathy.

In premature infants, 10% of retinopathy will rapidly progress to binocular blindness and will not be cured.

Does initial oxygen increase the probability of retinopathy? After the birth of a premature baby, oxygen must be given for a period of time, and there have been many previous claims that oxygen inhalation in premature babies increases the probability of retinopathy. Ding Xiaoyan, the person in charge, emphasized that non-standard oxygen inhalation for premature infants is likely to cause retinopathy of prematurity.

After several years of study and training, most of the hospital outpatient clinics, even county-level hospitals, can ensure standard oxygen inhalation. Thus, retinopathy in preterm infants is completely related to oxygen inhalation.

There are two key causes of retinopathy of prematurity: First, the younger the gestational age, the higher the prevalence. The probability of occurring at less than 28 weeks' gestational age is 80-90%, while the probability of occurring at around 32 weeks' gestational age is only 1 3, and most births after 36 weeks are less likely to occur.

The other is weight, although the baby is already 32 or 35 weeks old, the weight is very low, and other complications can occur all over the body. Various conditions such as ischemic, oxygen insufficiency, infantile pneumonia, etc., are all risk sources of retinopathy.

What about retinopathy in early neonatal babies**? Retinopathy of prematurity can be divided into stage 1 to 5, and once it reaches stage 5, it is considered to be relapsive. The person in charge of Ding Xiaoyan instructed her parents to come to the hospital on time to check their eyes according to the time proposed by the doctor, because it was calculated by the doctor in a disorderly sedan chair according to the calculation formula.

Fundus screening is not just done once for premature babies, but always observed that the physician feels that it is thoroughly safe. If it is one month after the expected date of delivery, which is commonly called, it is safe to correct the macula of the fundus after 44 weeks of gestational age.

Mainly because premature babies have a special physical fitness, so there may be some hunger problems in all aspects of the body, so every premature baby must go for fundus screening.

Because the body of premature babies is relatively fragile and premature babies are particularly susceptible to diseases, fundus screening is done.

Because the body of premature babies is very unhealthy, and there are many diseases at the same time, premature babies should have various examinations.

Because through this method, the health status of the newborn can be detected as soon as possible, and some effective records can be made in a timely manner.

Premature infants are susceptible to retinopathy of prematurity (about 10 incidences), and retinopathy of prematurity is one of the leading causes of blindness in children. If detected early, the child can maintain good vision. Once the ** time window is missed, the retina will rise and fall apart.

That is, the operation is not effective, and the child is likely to be completely blind.

The purpose of fundus screening is to detect retinopathy of prematurity in time and give corresponding ** in time.

In normal fetuses, there is significant vascular hyperplasia in 6-7 months. Arrived at the nasal serrated margin of Wuling at about 36 weeks (August). Retinal blood vessels of prematurity are not fully developed and continue to develop after birth.

It remains a vascular-free area around the periphery, particularly near the temporal serrated margin. The anterior tissues of the blood vessels, which are developing forward, have not yet differentiated into capillaries, and these tissues are very sensitive to oxygen. If the infant inhales high concentrations of oxygen, it is easy to cause vascular atresia and inhibit the formation of more blood vessels.

Prematurity, low birth weight, and oxygen administration are known causes of ROP. Normal newborns are born with vascularization of the limb chain around the retina and do not have the problem of immaturity.

Cui Yanhui, Beijing Children's Hospital.

Retinal blood vessels of prematurity are likely to be damaged by high concentrations of blood oxygen for long periods of time, resulting in retinopathy of prematurity. It is common at 4-6 weeks of birth, and parents and friends cannot judge the appearance. Retinopathy of prematurity should be seized to minimize the chance of visual impairment.

Fundus screening should be performed in preterm and low birth weight infants born at 32 weeks' gestation, or with a birth weight of <2000 g. If a baby has a serious illness or a history of oxygen supplementation, it is considered a high-risk group and should also have a fundus examination.

It is necessary to do all aspects of the examination.