Возможность и эффективность применения ангиопротекторов при ретинопатии недоношенных

Abstract

Purpose. To evaluate the effectiveness of Dicynone® (etamsylate) angioprotector in retinopathy of prematurity (ROP). Materials and methods. The study included premature babies. A total of 262 children born at 25–28 (27±2.5) weeks of gestation, weighing 914±247g. A retrospective analysis of case histories was carried out. There are 3 groups of clinical trials. In the first group, a comparative study of the prophylactic angioprotective therapy effectiveness for children at risk of developing ROP was carried out. The subgroup of children who received angioprotective therapy included 100 children. The control subgroup consisted of premature infants with a similar picture of the retinal fundus, who were not prescribed angioprotective therapy (100 children). Observation of children by an ophthalmologist was carried out according to the generally accepted protocol. The second group (42 children) consisted of children with type I retinopathy of prematurity: 22 children were prescribed Dicynone®intravenously; 20 children with a similar picture of the retinal fundus did not receive angioprotectors. The third group – children with signs of aggressive posterior ROP development. Results. A comparative study of the prophylactic use of angioprotectors in children at risk of ROP revealed a significantly lower number of cases of ROP in children who were prophylactically prescribed Dicynone®compared with the control group (p=0.0015). Prescription of angioprotective therapy against the background of the course of type I ROP led to a decrease in the activity of the process in 50% of cases. In 50% of cases, against the background of intravenous administration of Dicynone®, with the first clinical manifestations of aggressive posterior ROP, a decrease in vascular activity and exudative-hemorrhagic manifestations was observed, which made it possible to delay surgery by 1±0.6 weeks and perform laser coagulation with a more favorable somatic condition of the child. Conclusion. The use of angioprotective therapy for prophylactic purposes reduces the incidence of ROP and contributes to its favorable course in case of its development. Administration of angioprotective therapy against the background of the course of type I ROP helps to reduce the activity of the process and increases the likelihood of a favorable outcome. Key words: premature babies, retinopathy of prematurity, prevention, angioprotective therapy, pharmacological therapy of ophthalmopathology