Сравнительная характеристика эффективности лазеркоагуляции и введения ингибитора VEGF как методов лечения задней агрессивной ретинопатии недоношенных

Abstract

Aggressive posterior retinopathy of prematurity (APRP) is the most severe form of this disease and is difficult to treat. Purpose. Comparison of the effectiveness of the treatment of aggressive posterior retinopathy of prematurity with laser photocoagulation and the introduction of anti-VEGF. Material and methods. A comparative analysis of the case histories of 92 people (184 eyes) with aggressive posterior retinopathy of prematurity was carried out. Group I (58 people – 116 eyes) – laser coagulation of the retina was performed; Group II (34 people – 68 eyes) – intravitreal injection of a vascular endothelial growth factor (anti-VEGF) – Ranibizumab was used. The evaluation of the results was carried out according to three main indicators: stabilization of the disease, normalization of the periphery of the retina after treatment, as well as the time spent on providing anesthesia. Conclusion. The effectiveness of the treatment of aggressive posterior ROP was significantly higher with the introduction of the anti-VEGF – 97 % than with laser photocoagulation – 82.7 %, at p < 0.05. Complete regression of posterior aggressive ROP is observed significantly earlier after laser photocoagulation – 50.2 ± 2.17 weeks than after the introduction of the anti-VEGF – 63.5 ± 3.47 minutes, at p < 0.05. Normalization of the retina occurs significantly more often after the introduction of the anti-VEGF – 27.3 % than with laser photocoagulation, at p < 0.001. The time of anesthetic relief is significantly less with the introduction of the anti-VEGF – 7.5 ± 1.19 min. than with laser photocoagulation – 66.3 ± 13.7 min., at p < 0.001. Preferential intravitreal administration of the anti-VEGF is indicated for impaired visualization of the retina and its edema. Conclusion. In the treatment of posterior aggressive retinopathy of prematurity, intravitreal administration of the anti-VEGF is preferable. Given the novelty of this technique, the functional and structural outcomes of this manipulation are for further study. Keywords: anti-VEGF, laser photocoagulation, aggressive posterior retinopathy of prematurity, ranibizumab.