Neonatal fundus lesions

In fact, neonatal fundus lesions are also called retinopathy of prematurity in clinical medicine. This disease condition often occurs in premature babies. Since premature babies generally weigh less than normal newborns, their blood vessels are prone to underdevelopment at this time, leading to fundus lesions. The following will provide new parents with specific knowledge about neonatal fundus lesions.

1. Activity period

(1) The vascular change stage is seen in the early stages of retinopathy of prematurity. Both arteries and veins are tortuous and dilated. The diameter of the vein is sometimes 3 to 4 times larger than the normal diameter. Brush-like capillaries can be seen at the blood vessel endings in the peripheral part of the retina.

(2) Retinopathy stage: The lesions progress further, the vitreous becomes cloudy, and the fundus becomes more hazy than before. There is an increase in retinal neovascularization, which is mostly located near the equator, and can also be seen in the anterior or posterior pole of the equator. The retina in this area is obviously bulging, with blood vessels crawling on its surface, often accompanied by retinal hemorrhages of varying sizes.

(3) In the early proliferative stage, proliferative vascular cords appear at the localized retinal bulges mentioned above and develop into the vitreous body, causing small-scale retinal detachment in the peripheral part (most) or posterior pole (a few) of the fundus.

(4) In the moderate proliferative stage, the detachment extends to more than half of the retina.

(5) Complete retinal detachment during the extreme proliferative stage. Sometimes a large amount of blood can be seen in the vitreous cavity.

The active course of retinopathy of prematurity is 3 to 5 months. Not all cases go through the above five stages. About 1/3 of cases stop at the first stage, 1/4 stop at the second stage, and the rest stop at the third, fourth, and fifth stages and enter the fiber membrane formation stage.

2. Fiber membrane formation period

In the active stage, the cases that cannot subside on their own will eventually become scars and form fibrous membranes. The degree of scarring varies from mild to severe, and is divided into 1 to 5 degrees:

Grade I: The retinal blood vessels are narrow, the peripheral retina is grayish-white and turbid, with small irregular pigment spots, and there are also small turbidities in the nearby vitreous body, often accompanied by myopia.

Grade II: There is an organized mass in the peripheral part of the retina, which pulls the optic disc and retinal blood vessels to one side. There is a pigment arc at the edge of the opposite optic disc, and the optic disc is faded.

Grade III: The fibrous membrane pulls the retina to form one or several folds. Each wrinkle is connected to a membrane-like mass in the peripheral retina. The retinal blood vessels do not run along these folds, unlike congenital retinal folds.

treat

Once the disease occurs, it progresses rapidly and the time window for effective treatment is very narrow. Therefore, premature infants under 37 weeks of gestation should be examined promptly after birth, and those at high risk should be examined weekly. Laser or cryotherapy can be performed in stages 2 to 3 to coagulate the avascular area. In stages 4 and 5, vitrectomy is performed to remove the proliferative fibrovascular tissue and photocoagulation is performed at the same time to save vision.

I hope the above knowledge compiled by the editor can help everyone. Once the fundus lesions occur, it is not easy to treat. Parents should take comprehensive care of their children and learn basic knowledge about pregnancy and infant safety.