Клинико-эпидемиологические и терапевтические аспекты ретинопатии недоношенных детей

Abstract

Relevance of the study . Blindness and hypovision due to retinopathy of prematurity dominate in the structure of the causes of visual impairment from childhood in both developed and developing countries, despite all the achievements of science and practical medicine. A huge role in preventing blindness from retinopathy of prematurity belongs to the effectiveness of treatment. The most discussed topic among global ophthalmology community is readings and the time of laser coagulation of the eye retina. Aim of the study . To evaluate the advantages and disadvantages of laser coagulation various methods in retinopathy of prematurity, to determine the most optimal method in the treatment of active phases of the disease. Materials and methods . We consider retinopathy of prematurity modern methods of diagnosis and treatment, also we carry out advantages and disadvantages comparative analysis. We consider the organization statistics of ophthalmic care for premature infants in the Tambov Region and the long-term treatment results of premature infants with retinopathy of prematurity. Results and discussion . The generally accepted standard methodology applied for screening examination, is the reverse binocular ophthalmoscopy (possible in humidicrib) when medication dilate pupils. If necessary, an examination is carried out using the retinal pediatric camera “RetCam Shuttle” (Clarity Medical Systems Inc., USA), which allows to document and save the survey results in a database. To date, timely and sufficient laser coagulation of the avascular zone of the retina is the only proven effective method of active retinopathy of prematurity treatment. The most modern method of retinal laser coagulation is the technology of pattern scanning laser coagulation, which automated the procedure for applying coagulants. The main trends in the retinopathy of prematurity treatment are earlier implementation of laser coagulation and over dosed coagulation, according to the ETROP recommendations. When using a pattern laser system, laser pulses are delivered in sequence at the highest speed. The result of the use of this technology is a high accuracy of coagulation, so that the eye retina receives the least energy impact, compared with the classical laser coagulation. Conclusion. 1. Timely and adequate laser coagulation of the avascular areas of the eye retina reduces the risk of severe anatomical and functional outcomes of active retinopathy of prematurity. 2. The use of the technology of transpupillary scanning pattern laser coagulation of the eye retina (PASCAL) can significantly reduce the duration of laser exposure and anesthesia for a premature baby, improve the efficiency and safety of treatment.