Romero Daniel Alejandro Cando-Retinopathy of Prematurity-(Ecuador)

Name: Romero Daniel Alejandro Cando
Sex: Male
Nationality: Ecuadorian
Age: 2Y
Diagnosis: Retinopathy of Prematurity(ROP)
Discharge Date: 2018/07/19

Before treatment:
The patient was born by caesarean section at 30 weeks. He had respiration problems when he was born so did oxygen treatment for 15 days. When he was 6 months old his family found he had eye problems and he was diagnosed with retinal detachment in the right eye, a right eye cataract, partial retinal detachment in the left eye and ROP V. He did his first eye surgery in October 2017 to treat the cataract, retinal adhesion, lens separation and laser treatment for the left eye. His left eye vision was improved 5%. He had a second surgery in December 2017 to treat strabismus. In April 2018 he had a third surgery to put an Ahmed valve in the left eye and his vision was improved 3%. At present he has light sense in the right eye and he can see big and colorful objects at the distance of 5 cms in front of his left eye.
His sleep and spirit are normal. His diet, urination and defecation functions are normal.

Admission PE:
Bp: 85/55mmHg, Hr: 135/min, breathing rate: 26/min, body temperature: 36.8 degrees. Physical development was delayed and the patient had poor nutrition status. There is no injury or bleeding spots of his skin and mucosa and no blausucht. Chest development was normal and the respiratory sounds in both lungs were clear with no dry or moist rales. The heart beat was powerful with regular cardiac rhythm and no obvious murmur in the valves. The abdomen was flat and soft with no masses or tenderness. The liver and spleen were normal.

Nervous System Examination:
Patient was alert, he often beat his head or knocked his head on the bed or wall. He had poor speech and can only speak a few words such as Papa or Mama. He could not count numbers and could not cooperate with the examination of memory, orientation and calculation abilities. His pupils were valgus and it is difficult to distinguish his right side pupil. He could not chase light. The left side pupil diameter was 3mm, reaction to light existed, he could distinguish colorful big size objects at 5cm. His eyes fundus could not be detected. The bilateral forehead wrinkle and nasolabial fold are symmetrical, swallowing function and hearing ability were normal. His neck and 4 limbs could move freely and he could crawl but could not walk without support. The muscle tone was basically normal. He could not complete the muscle power examination. 4 limbs tendon reflex were normal, abdomen reflex was normal, sucking reflex was negative, bilateral palm-jaw reflex was negative. The Hoffmann sign of both sides were negative, Rossilimo sign was negative and the bilateral Babinski sign was negative. He could not cooperate with the sensory system and coordinate movement examinations. The meningeal irritation sign was negative.

After the admission he received 3 cell regeneration treatments (neural stem cells and mesenchymal stem cells) to repair his damaged retina, replace dead retinal cells, nourish optic nerves, regulate his immune system and improve blood circulation. This was combined  with rehabilitation training.     

After 12 days treatment his right eye had light sensation, he could chase the light and his left eye could see things at 10 cms distance.

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