Современные подходы к оказанию высокотехнологичной офтальмологической помощи детям с ретинопатией недоношенных в Калужском филиале МНТК «Микрохирургия глаза»

Abstract

Purpose. To present modern approaches to providing high-tech ophthalmic care to children with retinopathy of prematurity (ROP) in Kaluga branch of the S. Fyodorov Eye Microsurgery Federal State Institution. Methods. For the 2003–2022 period screening for detection of active ROP was carried out in 16 000 premature infants. Various stages of the disease were identified in 4129 premature infants (24.9 %). Premature infants with various stages and forms of active ROP have been subjected to multimodal diagnostics of changes in the vascular system of the eye since 2016. Early laser treatment by pattern laser coagulation of the retina using hexagonal patterns was carried out in 226 children (286 eyes) in 2016–2021. Transpupillary laser coagulation of the retina using navigatied laser system was performed in 16 premature babies (26 eyes) in 2021–2023. Primary vitrectomy for severe stage 3 active ROP with the development of extraretinal retinovitreal neovascularization involving the posterior hyaloid membrane was performed in 9 premature infants (12 eyes) in 2021–2023. Results. Based on a comprehensive analysis of the results of multimodal diagnostics, informative prognostic signs of the type of active ROP were established, according to the data of fluorescein angiography of the fundus, spectral optical coherence tomography in the angio mode, and color duplex scanning. These signs provide an accurate definition of the type of course of the disease – a decisive factor in the choice of tactics for managing patients. The developed technologies of pattern hexagonal and navigatied laser coagulation of the retina provide maximal percentage of disease regression. These technologies create the most favorable conditions for further development of visual functions. Primary vitrectomy in all cases made it possible to achieve stable regression of the pathological process. Conclusion. Modern approaches to the provision of high-tech ophthalmic care for children with ROP, implemented in Kaluga branch of S. Fyodorov Eye Microsurgery Federal State Institution, provide high efficiency in the treatment of active ROP with a minimal risk of late complications in the cicatricial period of the disease. Key words: retinopathy of prematurity; multimodal diagnostics; navigated laser coagulation of the retina; primary vitrectomy.