Retinopathy of prematurity. 10 years of experience

Abstract

VISION2020 is a global initiative of the International Agency for the Prevention of Blindness, whose mission is the elimination of avoidable blindness by the year 2020. The key elements of VISION2020 are a) strategies for the control of the major blinding eye diseases (cataract, trachoma, onchocerciasis, blindness in children, refractive errors, and low vision), b) infrastructure development and supplying and maintaining equipment, c) human resource development, and d) community participation. Blindness from ROP is recognized as a priority for the whole world. Globally there are estimated to be 60,000 children who are blind from ROP. Retinopathy of prematurity (ROP) is a potentially avoidable cause of blindness in children. ROP is an actual problem for perinathologists and ophthalmologists concerning the progress in neonatology for the past years. The first steps in the ROP screening and diagnose were made as a part of the project „Avoidance of possible blindness in children” sponsored by WHO and LIONs CLUB in 2005. There were prepared specialists in ROP. Necessary equipment was bought. In 2013 the team from Moldova participated at the ROP workshop for Black Sea region under the guide of the International Agency for the Prevention of Blindness (IAPB). During this visits have been reported preliminary datas and directions of activity in the field of ROP. In 2014 grateful to the support of Kinder Sollen Sehen (Germania) organization the ophthalmology service from Moldova that deals with ROP has been totally assured with the necessary equipment. There were organized meetings with experts from Lithuania and neonathologists regarding ROP issues. In 2015 was approved the National Protocol in ROP. Two of our specialists has undergone a training in ROP diagnose and treatment in Turkey (with the support of TIKA-Turkish Cooperation and Coordination Agency). Informative materials have been published for parents with ROP children. Statistics show that in the perinatologic center of the Mother and Child Health Care Institute in 2014 were delivered 942 children, 442 of them new-borns premature, mature- 500. 90% of all from the Follow Up Center undergone an ophthalmologic control. Implementation in the RM of the ophthalmologic screening and monitoring, the increase of the premature children; an increased attention for the risk factors for the ROP development – are the main directions in the blindness prevention in children. Primary prophylaxis and screening as a nurse is organized by meetings for parents regarding the birth of a premature baby, the necessity for the pregnant woman observation by the family doctor, gynecologist, and treatment of the chronical sources of infection. The interaction criteria of the medical assistance are compulsory: gynecologists, perinatologists, nurses that outline the risk factors for premature birth and direct this woman to the ophthalmopediatrician. Also they select the ROP risk factor pregnant woman, children with acute stages of ROP and the ones that need Laser or crio treatment. Conclusions: The implementation of a screening system and monitoring of ROP in Moldova has been possible as a support from the European partners as a true example of co-operation. The aim for the future is to create the database for the premature babies with their retina photos.