Pediatric and neonatal retinal disorders
Retinopathy of prematurity is a serious cause of blindness in some babies who are born prematurely. The retinal blood vessels do not develop completely until the ninth month of pregnancy. When babies are born prematurely, there is a region of retina that has no circulation. Often the retinal blood vessels will continue to develop following birth and no problems will occur. However, in some patients, abnormal blood vessels develop which cause scar tissue to grow into the eye. The scar tissue can pull on the retina causing it to detach from the wall of the eye. Although surgery can be performed on babies with retinal detachments, the prognosis for recovery of vision is very poor.
A national collaborative study has published results that show that treatment to this the region of retina with no blood supply tends to reduce the chances of blindness in patients with retinopathy of prematurity and abnormal blood vessel growth. This study found that without treatment there was a 50% chance of severe visual loss or blindness whereas with treatment, the chances of severe visual loss were reduced to 20%. The treatment to thin the peripheral retina was originally done with freezing (cryopexy) treatment. More recently, however, the treatment has been done with laser photocoagulation. Additional studies have shown that laser photocoagulation is equally effective and better tolerated then cryotherapy in reducing the chance of severe visual loss.
As with any treatment or operation, there are possible complications. These include hemorrhage and retinal detachment. However, if no treatment is performed, there is an even greater chance of retinal detachment or hemorrhage occurring in the eye.