Early treatment of retinopathy benefits premies

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van Heuven

(San Antonio – Dec. 16, 2003) A study reported this month by the National Eye Institute suggests early surgical treatment of the blinding condition retinopathy would help thousands of premature, low birth weight babies annually. The Health Science Center was one of the clinical centers involved in the Early Treatment for Retinopathy of Prematurity study.

Dr. W.A.J. van Heuven, professor and chairman of the department of ophthalmology, and Dr. Alice Gong, associate professor in the department of pediatrics/division of neonatology, led the South Texas study. “We have been a partner with National Eye Institute-sponsored retinopathy studies for the last 18 years and this is the most recent study,” Dr. van Heuven said. “It refines further our understanding of when the best time is to intervene surgically with lasers to achieve the best possible results for these babies who are going blind.”

Retinopathy of prematurity (ROP) is marked by the growth of abnormal blood vessels in the back of the eye. Leakage from the vessels may scar nerve tissue, possibly resulting in impaired vision or blindness. Because ROP progresses differently in each infant, it poses difficult treatment decisions. ROP usually resolves by itself, but one in 10 affected babies requires laser surgery as early as possible to enhance vision.

Ophthalmologists have been limited by a lack of clinical criteria to predict which patients will have severe vision loss.

“Even using these latest criteria for treatment, there are going to be babies who with the best and earliest treatment still go blind,” Dr. van Heuven said. “Thus, research needs to continue until no babies go blind from retinopathy of prematurity.”

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Gong

Dr. Gong added: “This is a very important study to help ophthalmologists and neonatologists refine the best time to intervene with treatment in a premature baby’s eyes in order to prevent blindness. Earlier studies have shown us that treatment is effective; we now know that treating at an earlier stage is beneficial to premature babies. Having eyesight contributes greatly to normal health and development of these babies, who already have had so many health problems from birth. As a result of this study, we may be able to have more premature babies without significant developmental problems.”

Dr. van Heuven noted that the local studies have been in collaboration with community retina specialists and the University Hospital and Christus Santa Rosa Children’s Hospital neonatal intensive care units. Drs. van Heuven, Gong and Christopher Macdonald participated in this study from the Health Science Center. Community retina specialists Drs. Timothy Cleland, Lina Marouf and Juan Rubio also participated.

The Early Treatment for Retinopathy of Prematurity study results are in the December issue of the Archives of Ophthalmology.



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