Оптимизация ранней диагностики развития и прогрессирования ретинопатии недоношенных

Abstract

Purpose. To develop easy-to-use methods for early diagnosis of the development and progression of retinopathy of prematurity (ROP). Мaterial and methods. The extracellular peroxidase activity (EPA) of blood serum was studied by spectrophotometry in 93 premature newborns aged 3–4 weeks of life and the thickness of the retinal neuroepithelium (NES) of the paramacular zone by measuring it at a distance of 500 μm from the border of the foveola in 82 premature infants (162 eyes ) using optical coherence tomography (OCT) of the retina on the RetinaScan — 3000 device (NIDEK) in the Macula Multi Cross mode. Results. Determination in premature newborns at 3–4 weeks of life of the level of blood serum VPA less than 1887.1 c.u. allows predicting the development of ROP in 76.4 % of cases. At the same time, there is an inverse correlation (R = –0.94; p < 0.05) between the value of the VPA and the pathology of the upper respiratory tract (respiratory distress syndrome, respiratory failure, asphyxia). The study of the thickness of the paramacular zone of NES showed an increase in its values, regardless of the stage and form of ROP. At the same time, the average thickness index was higher by 39.0 μm in infants with ADHD compared with stage I of the classical form, by 39.3 μm — by stage II, by 35.8 μm — by stage III (p < 0.05). Stabilization of the pathological process was accompanied by a decrease in the NES thickness index (p < 0.05). Conclusion. Examination of the values of extracellular peroxidase activity in the blood serum at 3–4 weeks of life of a premature newborn, as well as monitoring the thickness of the retinal neuroepithelium in the paramacular zone, allow timely diagnosis of retinopathy of prematurity. Keywords: retinopathy of prematurity, diagnostics, extracellular peroxidase activity, retinal neuroepithelial thickness