Muhammad Essa Nasir-Retinopathy of prematurity stage V (ROP V)-(Pakistan)

Patient Name: Muhammad Essa Nasir
Gender: Male
Age: 1 year and 7 months
Nationality: Pakistan
Diagnosis: Retinopathy of prematurity stage V (ROP V)

Before Treatment:
The patient is a premature infant (born at 24 weeks, weighing 1500g) with a history of oxygen therapy for 2 months. He was later found to have no vision and was diagnosed at a local hospital with "Retinopathy of Prematurity Stage V." The local hospital offered no treatment options, and the patient's vision has not improved since birth.

Admission Examination:
The patient's pulse was 116 beats per minute, respiratory rate was 26 breaths per minute, height was 80 cm, and weight was 9 kg. He showed delays in language and motor development, with general nutritional status. His breath sounds in both lungs were clear. His heart sounds were strong, with a regular rhythm and no murmurs. His abdomen was soft, with no enlargement of the liver or spleen.

Neurological Examination:
The patient is alert but has delayed language development. He could only produce single syllables and occasionally called for "Dad" or "Mom." His both pupils were approximately 3.0 mm in diameter. He had no vision in either eye but showed light perception with bright light sources (such as sunlight or a flashlight), with slightly better sensitivity in the left eye compared to the right. His both eyes had a sluggish light reflex. His left eye exhibited esotropia (inward squint). Fundus examination revealed abnormal vascular and fibrous proliferation in both eyes, with a dark yellow appearance of the fundus. The ratio of arteries to veins was about 1:3, and there was bilateral retinal detachment. His neck was supple. Muscle strength in his all four limbs was grade 5, and muscle tone was normal. He could roll over but could not crawl, stand, or walk. His deep tendon reflexes were present, and there were positive pathological signs in his both lower limbs. He had intact superficial and deep sensation. There were no signs of meningeal irritation.

Treatment Process:
The patient was admitted with a confirmed diagnosis of "Retinopathy of Prematurity Stage V (ROP V)." He received mesenchymal stem cells and neural stem cells to repair the retina and optic nerve, along with adjunctive CAST therapy to nourish the retina and optic nerve, improve circulation, and modulate the immune response. Comprehensive visual rehabilitation was also incorporated into his treatment plan.

After Treatment:
The patient showed an increased sensitivity to light in both eyes, with improved light reflexes. He can quickly and accurately locate light sources, and at a distance of 10 to 15 centimeters, he can see finger movements and brightly colored objects. He is now able to grasp toys using his vision. Fundus examination revealed significant improvement in blood flow to the retina, with the fundus appearing light orange in color, reduced fibrosis, and an artery-to-vein ratio of approximately 2:3.