Vision-related quality of life in children with retinopathy of prematurity

retinopathy of prematurity

Technological advances in the medical field in the last century were the most important in the history of mankind. On the one hand, life expectancy was significantly increased and on the other, infant mortality was greatly reduced. The increase in life expectancy led to the emergence of many chronic non-infectious diseases, as well as the over-life of premature children gave rise to a new branch of medicine, neonatology and with it also a series of ophthalmological pathologies, the more important retinopathy of prematurity. 

With the advancement of medical sciences and the deepest pathophysiological study of this entity in the 1980s he was decided to call retinopathy of prematurity. 

Normally the retina is vascularized at 40 weeks after conception, that date usually coincides with the birth. If the fetus is born prematurely, it is possible that the retina is not vascularized to the periphery, so that retinal vascularization can be stopped with childbirth and exposed to high or even normal concentrations of oxygen. The peripheral retina experiences ischemia and releases angiogenic factors that cause abnormal retinal neovascularization, with vessels that can bleed and cause traction on the retina. two 

When a premature baby is born, due to his lung immaturity, oxygen must be incorporated, necessary for his life and brain function, this inhibits the stimulation of growth of the retinal vessels, producing a false state of normality; There is an imbalance between the amount of retina to be irrigated and the number of vessels developed. This forms a retina without vessels and an area of ​​the vascularized retina. 

The main factors associated with retinopathy of prematurity are prematurity, low birth weight, oxygen use and sex. Naturally, the problem tends to be more frequent in children born at extremely low gestational ages (24-27 weeks) and with very low birth weight (MB PN) (800 g). However, the disease persists in many parts of the world in newborns (more than 32 weeks gestation) and more than 1 750 g of weight. There have been studies that evaluate other risk factors such as the use of erythropoietin, the presence of neonatal sepsis and the decrease in light therapy in premature infants.  

The low vision services have the function of raising the quality of life of these patients, preserving and potentiating the remaining vision through visual rehabilitation, in the stimulation at an early age or early intervention which has as a basic objective that the child confers a meaning to the visual stimuli it receives, so that it can become a maximized visual process. 

All this knowledge and data about the retinopathy of prematurity that appears every day in the world literature and the importance of updating the behavioral information of this pathology in our environment and the way they influence the survival of our childhood, motivated us to the realization of this work where we hope to evaluate the behavior of this disease, determine the most frequent refractive disorders as well as the most used optical aids in visual rehabilitation and finally evaluate the visual results achieved and be able to avoid as far as possible child blindness that therefore it leads us to an increase in the population with visual impairment.