Muhammad Essa Nasir-Retinopathy of prematurity stage V (ROP V); Developmental delay and Autism--(Pakistan)

Patient Name: Muhammad Essa Nasir
Gender: Male
Age: 2 years and 3 months old
Nationality: Pakistan
Diagnosis: Retinopathy of prematurity stage V(ROP V); Developmental delay and Autism.

Before Treatment:
The patient was a premature infant (born at 24 weeks gestation, weighing 1500g) with a history of oxygen therapy for 2 months. It was discovered that he had no vision and was diagnosed at a local hospital with "Retinopathy of Prematurity Stage V." The local hospital had no treatment options, and his vision had not improved since birth. 6 months ago, the patient came to our hospital, and after 2 weeks of treatment, his visual function improved, allowing him to see large objects and follow his family members. He was re-admitted for further treatment.

Admission Examination:
Patient's pulse: 107 beats/min, respiration: 22 breaths/min, height: 92 cm, weight: 12 kg. He had no speech and exhibited delayed motor development, walking unsteadily and unable to climb stairs. Bilateral lung sounds were clear. Heart sounds were normal with sinus arrhythmia, and no murmurs were noted in the valve areas. There was no enlargement of the liver or spleen.

Neurological Examination:
The patient was alert but had no speech, only able to produce single syllables. He exhibited compulsive behaviors (such as head-banging) and had no interaction with the outside world. Both pupils were approximately 3.0 mm in diameter, with light reflex present in both eyes, more responsive in the left eye compared to the right. His left eye was positioned inward (esotropia). Fundoscopic examination showed a pale yellow fundus in both eyes with abnormal blood vessels and fibrous proliferation, indicating bilateral retinal detachment. His forehead wrinkles were symmetrical, but he did not cooperate with tongue protrusion. His neck was supple, and he had normal muscle strength (grade 5) and tone in all limbs. He could roll over and crawl, could stand and walk but did so unsteadily and could not climb stairs. Tendon reflexes were present, and there were questionable positive pathological signs in the lower limbs. Both deep and superficial sensations were intact. There were no signs of meningeal irritation.

Treatment Process:
Upon admission, the patient was clearly diagnosed with "Retinopathy of Prematurity Stage V (ROP V), developmental delay, and autism." He was treated with mesenchymal stem cells and neural stem cells to repair the retina, optic nerve, and brain nerves. Additionally, CAST therapy was administered to nourish the retina and brain nerves, improve circulation, and regulate the immune system. This was combined with comprehensive visual rehabilitation and other supportive treatments.

After Treatment:
The patient's condition improves significantly. His sensitivity to light increases in both eyes, allowing him to quickly and accurately locate light sources and grasp small toys. The distance at which he can see objects increased; he is able to recognize family members, and his visual field expands. Instances of crying and fussiness decrease, and he shows improved cooperation during examinations, with a reduction in compulsive behaviors. His language skills improves as well, with the emergence of a few single words. His limb mobility increases and becomes more flexible, with a notable improvement in his ability to climb stairs. Fundoscopic examination reveales improved retinal blood flow compared to admission, with the retina appearing orange-yellow, a reduction in fibrous proliferation in both eyes, and an improvement in the degree of retinal detachment.