Abstract
Purpose: Analysis and prognostic outcomes of retinopathy of prematurity (ROP) depending on the solar activity at birth time and gestational age. Material and methods. 229 case histories of premature babies born within 2017-2019 were randomly selected. They were split into two groups: group I – children with ROP (1, 2 and 3 degree) and group II – without any ROP (pre retinopathy). The disease outcome was taken into account in the children with ROP: laser coagulation (LC) and spontaneous regression. Also, all children were split according to the seasons of birth: winter, spring, summer and autumn. Results. The seasonal differences in retinopathy outcomes were observed: in children born in spring and summer, the percentage of spontaneous regression was much lower and was 15% in spring, 13.2% in summer, 29% in autumn and 29.6% in winter. The percentage of performed LC on the contrary was 21.7%-28.3% in spring and summer period and 9.7%-14.8% in autumn and winter. Conclusion. A mathematical model is constructed for predicting the outcome of retinopathy of prematurity, determining the probability of spontaneous regression of the disease based on such independent variables as the level of insolation and the gestational age of the child. According to the obtained formula, the probability of spontaneous regression of retinopathy increases with an increase in gestational age and a decrease in solar activity at birth time. On the contrary, the probability of need for laser coagulation increases with a decrease in gestational age and an increase in the insolation intensity.
Highlights
Material and methods. 229 case histories of premature babies born within 20172019 were randomly selected. They were split into two groups: group I – children with retinopathy of prematurity (ROP) (1, 2 and 3 degree) and group II – without any ROP
The disease outcome was taken into account in the children with ROP: laser coagulation (LC) and spontaneous regression
The seasonal differences in retinopathy outcomes were observed: in children born in spring and summer, the percentage of spontaneous regression was much lower and was 15% in spring, 13.2% in summer, 29% in autumn and 29.6% in winter
Summary
В настоящее время благодаря совершенствованию методов выхаживания и развитию службы интенсивной терапии и реанимации неуклонно увеличивается выживаемость глубоко недоношенных детей [5]. В связи с этим появились работы, направленные на изучение влияния воздействия солнечного света на сетчатку недоношенных детей. Что работы по исследованию влияния солнечного света на развитие ретинопатии недоношенных единичны, многие авторы сходились во мнении, что уменьшение воздействия на сетчатку недоношенных детей яркого света не влияет на частоту развития заболевания. Однако проведенные до настоящего времени клинические исследования показали противоречивые результаты влияния света на развитие болезни у доношенных детей [7]. В работах Yang MB et al 2013 г установлена взаимосвязь длины дня во время ранней гестации и риска развития РН. Методом множественной логистической регрессии авторами была получена прогностическая модель РН и показано, что продолжительность светового дня в течение первых 90 дней после предполагаемого зачатия ассоциируется с развитием РН, следовательно, число случаев ретинопатии недоношенных в весеннелетний период было значительно выше, чем в осенне-зимний [8]. Есть основания полагать возможность проведения математического прогноза риска развития РН в зависимости от солнечной активности
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