Retinopathy of prematurity prevention, therapy, and prognosis. Eye surgery. 5

Retinopathy of prematurity prevention, therapy, and prognosis.  Eye surgery. 5

Retinopathy of prematurity prevention, therapy, and prognosis. Eye surgery. 5

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Retinopathy of prematurity is one of the major causes of childhood blindness. Many premature babies with very low birth weight survive today. So retinopathy of prematurity is a big problem. How to prevent retinopathy in premature babies? How to diagnose retinopathy of prematurity? What are the best treatment methods for retinopathy of prematurity? Very, very good question. Because retinopathy of prematurity is a really real blindness problem for some very young babies, so we need to have the best quality screening retinopathy of prematurity. And after that, we go to the treatment of retinopathy of prematurity. But first of all, it is the screening. And for the screening, we need to have some larger diagnostic methods that are easy to use for looking at the retina. And so, there is new retinopathy diagnostic methods. These new diagnostic methods are better than what we were doing in the past. When I was a resident, we were going to patients with a headset to just look at the retina. And it was so difficult, because the child is so small, and so the eye is small also. And it was very complicated. Now we have retina diagnostic systems with a handpiece. This handpiece has a very wide fundus. So we have wide-field fundus. And I think the best feature of modern retinopathy of prematurity diagnostic methods is that the handle piece is independent of the machine. It's very easy to use. And so, it has made diagnosing retinopathy of prematurity easier. The screening in some centers is done by nurses. And I think this is very, very interesting. It's, of course, very difficult because nurses in neonatology are very busy. But if we can find, I mean, a professional paramedic who could handle looking at the retina, it will be very good. And so we work also on transmission of the images via telemedicine. And so that's very interesting also because you are not obliged to be on the at the bedside for diagnosis. But if you have someone who takes the pictures first, then the retinal surgeon or the retinal specialist can look at the images and say, "okay, no, don't worry, we stay here, just do the follow-up". "No, this patient must be going to the specialized retina center, and we will apply a treatment for retinopathy of prematurity." So what are the treatment of retinopathy of prematurity? We have different treatments for retinopathy of prematurity. We have a new treatment with anti-VEGF injection, which are useful. There was a nice publication in the New England Journal of Medicine some years ago that demonstrated the use of anti-VEGF for retinopathy of prematurity. That was very interesting. It is not the only treatment of retinopathy of prematurity. We must stop the new vascularization that is just growing in a damaged retina. And the other treatment is retinal surgery if needed. But for sure, we just have to use the laser as little as possible. The anti-VEGF injection can also be combined. The last possible resort for retinopathy of prematurity is retinal surgery. Because when we go to retinal surgery, we know that the prognosis is not very good. And so that's why early diagnosis of retinopathy of prematurity is the key to treatment success. That is very interesting that you mentioned the application of telemedicine increasing in use because it allows the scalability of the screening by somebody who is not necessarily a retinal disease specialist. But reviewing the images remotely will help to diagnose these babies with retinopathy of prematurity and hopefully will start the non-surgical treatment of retinopathy of prematurity early. Exactly. The early screening for retinopathy of prematurity is also the key to success.

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