Objective.The aim of the study was to determine the possibilities and develop practical recommendations for optimizing the personalized tactics of laser surgical interventions in the treatment of retinopathy of prematurity in the early stages of the disease.
Materials and methods. We enrolled 107 infants (total sample of 214 eyes) of the Minsk region with the established diagnosis of retinopathy of prematurity 3- 3+ stagefor the period 2014—2019. The patients were divided into subgroups according to the treatment: laser ablation at the threshold stage (ETROP) and at an earlier time before the development of the threshold stage (pre-ETROP). The average gestational age of children at birth was 28 (28—29) weeks, the ratio of boys and girls was 51.88%: 48.11(c2=1.2, p=0.746). The average birth weight was 1005 (990—1100) grams, H=18.43, p<0.001.
Results.The primary laser treatment was carried out in the period of 32-36 weeks of gestationalage. The results of the study showed no recurrence and a stable result in the eyes of infants of subgroup B (pre-ETROP) compared with 12.9% of recurrence in subgroup A (ETROP). (22=51.1 p<0.001), (U=395.0 p<0.001), in subgroup A further development of the disease was noted in 25.8% (c2=36.4 p<0.001).
Conclusion. An earlier start of treatment of the 3-3+ stage of PH prevents the development of retinal detachment, allows you to preserve the functional neuroepithelium in a larger volume. A rapid and stable success of treatment of retinopathy in the eyes of infants of subgroup B was noted in comparison with subgroup A (c2=8.9 p=0.030). Early “active” management of patients allowed to control the disease with a smaller number of surgical interventions and with more “gentle” parameters of laser ablation (H=55.6 p<0.001).
Ключевые слова:Автор(ы): H. A. Sushchenia