Особенности офтальмологического статуса и факторы риска у пациентов с ретинопатией недоношенных

Abstract

Aim. To identify risk factors for the development of retinopathy of prematurity and features of the ophthalmological status in dynamics, after two years. Materials and methods. The analysis of outpatient records of 638 premature babies for three years was carried out, of which 309 girls (48.44%) and 329 boys (51.56%) were observed in the consulting and diagnostic office for the identification and monitoring of children with retinopathy of prematurity in Tyumen. Results. The study showed that boys developed more severe stages of PH. The analysis of gestation periods in the groups revealed its significant effect on the development of PH (p < 0.05). Patients with a gestation period from 24 weeks to 27.5 weeks are 1.7 times more common in patients of groups 2 and 3 compared to group 1. There was a significant (p ≤ 0.03) increase in the proportion of patients with extremely low body weight (from 500 to 1000 grams) in groups 2 and 3 compared to group 1. In all groups, the majority of patients have anemia, a syndrome of respiratory disorders. Bronchopulmonary dysplasia and intra-ventricular hemorrhages of 3-4 degrees are more common in patients in groups 2 and 3 with a significance level of p = 0.003 and p = 0.001, respectively. The analysis of the clinical course of PH showed the dependence of spontaneous regression of the disease on the stage: it occurred only in patients of groups 1 and 2. Laser retinal coagulation was required in 82.6% of cases in patients of group 3, after which induced self-regression occurred. The inability to perform laser retinal coagulation was noted in 4.3% of cases due to the severity of the somatic status. Dynamic observation of the ophthalmological status for two years showed the absence of pathology in patients of group 1 and its increase depending on the severity of PH: in patients of group 2 in 15% of cases, in patients of group 3 in 65.22%. The revealed ophthalmological pathology includes accelerated refractogenesis, refractive errors, pathology of binocular vision, atrophy of the optic nerve, congenital glaucoma. Conclusion. Further study of risk factors for retinopathy of prematurity, methods of its treatment and their influence on the state of ophthalmological status in dynamics is required. Children who have undergone retinopathy need careful observation by an ophthalmologist throughout the entire period of growth and formation of visual functions.