Morphological hallmarks in early stage retinopathy in premature babies (retrolental fibroplasia)

Abstract

Retinopathy in premature babies, also called retrolental fibroplasia, is one of the leading causes of visual impairment in the pediatric population. The condition occurs in developed countries and the pathophysiological mechanisms for its development are due to the overall immaturity of the body, in particular the respiratory system. The need for the baby to be kept in a highly oxygenated environment, against the background of pantissue hypoxia, results in the proliferation of retinal vessels subsequently sprouting into the posterior ocular chamber. As the respiratory system matures, the vessels degenerate and are replaced by connective tissue, which can lead to many complications. In order to detect early vascular changes in the retina, the ocular bulb of a pediatric autopsy case was examined, associated with early changes of premature retinopathy and a single control pediatric autopsy without clinical data on retinal pathology. Both patients were of comparable age - 3 months. In the patient with clinical manifestations of retrolental fibroplasia in the outer layers of the retina, there was profound proliferation of blood vessels, including thick-walled ones, with impaired histoarchitectonics of the retina. The second patient presented with no clinical data and conventional retinal morphology without vascular proliferation. The condition does not require morphological diagnosis. The observational findings of fundoscopy, together with the clinical information, are often specific enough and with good therapeutic interventions - lung rehabilitation, control of the oxygen environment, it is possible for the changes to regress without pathological progression. Morphological diagnosis is indicated only in cases with missing medical records, clinical evidence of visual impairment and the need for differential diagnosis with other disorders in the retina, some of which may have a genetic etiology and pose a potential risk to other relatives.