United Arab Emirates: Timely intervention saves premature baby’s vision

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

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

Over the course of an 84-day stay in the Neonatal Intensive Care Unit (NICU), the little warrior encountered a series of medical obstacles, including respiratory failure, anemia, urinary tract infection and sepsis. However, the baby showed remarkable resilience throughout the trip.

The turning point in the baby’s medical journey occurred when the baby experienced sustained apnea (temporary cessation of breathing) and pupil dilation 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 high if the baby is born very low weight or very early.

As ROP worsens, the blood vessels may become thick and wavy, called Plus disease.

About 32,300 children worldwide are diagnosed with irreversible visual impairment due to ROP annually, of whom approximately 20,000 become blind or have severe visual impairment. Despite significant advances in neonatal care, the global number of babies with ROP has increased as the survival rate of premature babies increases.

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

These babies begin to develop abnormal blood vessels in the retina, which can rupture and bleed spontaneously, which could lead to permanent blindness if not treated in time. After a comprehensive pre-anesthesia evaluation, the medical team devised a plan for peripheral laser photocoagulation with the IDO (indirect) laser.

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

General anesthesia allowed for painless treatment while precisely targeting the affected retinal areas, minimizing damage to healthy tissue. During the 40-minute laser photocoagulation procedure, the medical team closely monitored the baby’s vital signs and made any necessary adjustments.

After the procedure, antibiotics and lubricants were administered, and the baby was safely inverted, extubated and closely monitored until fully awake, hospital administration said.

Dr. Murugavel said, “At Aster Hospital, our commitment is to provide comprehensive care to premature babies, with special focus on specialized eye care. Ensuring the overall well-being of these vulnerable babies is our top priority and we are dedicated to preserving their vision and well-being. “Timely intervention is crucial to preventing irreversible vision loss and reflects our mission to provide comprehensive care for premature babies.”

Commenting on anesthesia management, Dr Murthy said: “Anesthesia management for premature babies with complex medical histories requires a high level of precision and care. “We closely monitor 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.