UAE: Timely intervention saves premature baby’s vision

Dubai: A premature baby nearing vision loss at the age of four months has undergone successful treatment for a complex case of Stage 3 Retinopathy of Prematurity (ROP).

Dubai-based Aster Hospital, Al Qusais revealed it recently marked a medical milestone by treating the complex case in a premature Filipino infant.

The achievement was the result of a collaborative effort between Dr Boopathy Murugavel, an ophthalmology specialist, and Dr Manish Srinivas Murthy, an anaesthesiology specialist at the hospital, it said.

The patient, an extremely premature infant born at only 25 weeks and six days through a natural delivery, had an initial birth weight of just 918 grams.

Remarkable resilience

Over the course of an 84-day stay in the Neonatal Intensive Care Unit (NICU), the tiny warrior encountered a series of medical hurdles, including respiratory failure, anaemia, urinary tract infection, and sepsis. Nevertheless, the baby displayed remarkable resilience throughout their journey.

The turning point in the baby’s medical journey occurred when the infant experienced sustained apnea (temporary cessation of breathing) and dilation of the pupils while undergoing an eye examination in the Neonatal Intensive Care Unit (NICU).

Thus, at the age of four months and 25 days, the baby received a diagnosis of Stage 3 ROP with Plus Disease in both eyes. Retinopathy of prematurity is a condition in which certain babies born prematurely do not have properly developed blood vessels in the retina. This risk is particularly elevated if the baby is born with very low weight or very early.

As ROP gets worse, the blood vessels may get thick and wavy and this is called Plus Disease.

Some 32,300 infants worldwide are diagnosed with irreversible vision impairment due to ROP annually, of which approximately 20,000 become blind or severely visually impaired. Despite significant advances in neonatal care, the worldwide number of infants with ROP has been increasing as the survival rate of premature babies has increased.

Under the care of Dr Boopathy Murugavel and Dr Manish Srinivas Murthy, the baby was admitted for treatment, presenting with anaemia of prematurity and retinopathy of prematurity.

Abnormal blood vessels

Such infants start to develop abnormal blood vessels in the retina, which can spontaneously rupture and bleed, potentially leading to permanent blindness if not treated promptly. Following a comprehensive pre-anesthesia evaluation, the medical team devised a plan for peripheral laser photocoagulation with IDO (Indirect) Laser.

The baby underwent a careful anaesthesia management procedure, including intubation and maintenance under general anaesthesia, due to the discomfort associated with neonatal laser therapy.

General anaesthesia allowed for painless treatment while precisely targeting the affected retinal areas, minimising harm to healthy tissue. Throughout the 40-minute laser photocoagulation procedure, the medical team closely monitored the baby’s vital signs, making necessary adjustments.

Post-procedure, antibiotics and lubricants were administered, and the baby was safely reversed, extubated, and closely monitored until fully awake, the hospital management said.

Timely intervention crucial

Dr Murugavel stated: “At Aster Hospital, our commitment is to provide comprehensive care for premature babies, with a particular focus on specialised eye care. Ensuring the overall welfare of these vulnerable infants is our top priority, and we are dedicated to preserving their vision and well-being. Timely intervention is crucial to prevent irreversible vision loss, and it reflects our mission to provide holistic care for premature infants.”

Commenting on the anaesthesia management, Dr Murthy said: “Managing anaesthesia for premature infants with complex medical histories requires a high level of precision and care. We closely monitored the baby’s vital signs throughout the procedure, ensuring a successful outcome.”

The baby, now in stable condition, has been discharged and is under the supervision and care of a pediatrician.