RESUMEN
PURPOSE: The study aims to determine the indications and evaluate the results of primary vitrectomy in unfavorable progression of stage III active retinopathy of prematurity (ROP). MATERIAL AND METHODS: The control group consisted of 17 patients (28 eyes) with unfavorable progression of stage III ROP, who had the disease progress after coagulation of the avascular retina and underwent the second stage of treatment - vitrectomy. The main group consisted of 5 patients (10 eyes) with unfavorable progression of stage III ROP, who underwent primary vitrectomy. Gestational age at birth was 24-30 weeks, body weight ranged from 680 to 1250 g. According to spectral optical coherence tomography (SOCT) and OCT angiography (OCT-A), the initial state of the retina and vitreoretinal interface in patients of the main and control groups were identical. RESULTS: A retrospective analysis of control patients, according to SOCT and OCT-A data, showed the spread of neovascularization beyond the retinal plane, its interaction with the posterior hyaloid membrane and vitreous body structures in the early stages of the disease, traction changes in the underlying retina, areas of retinoschisis, as well as thickening of the posterior hyaloid membrane. The tactics of treating patients with unfavorable progression of stage III ROP has changed since 2020. Primary vitrectomy was performed in case the signs listed above were identified. The transition of the disease to the inactive stage was recorded in all cases one month after primary vitrectomy. After one year the pathological process did not reactivate in any of the cases, and no pathological changes were found in the projection of the former proliferation ridge. CONCLUSIONS: Extraretinal retinovitreal neovascularization, according to multimodal preoperative diagnostics, indicates the need for vitreoretinal surgery as a pathogenetically substantiated method of treatment for unfavorable progression of stage III active ROP.
Asunto(s)
Retinopatía de la Prematuridad , Recién Nacido , Humanos , Lactante , Retinopatía de la Prematuridad/diagnóstico , Retinopatía de la Prematuridad/cirugía , Vitrectomía , Estudios Retrospectivos , Coagulación con Láser/métodos , Retina/diagnóstico por imagen , Retina/cirugía , Retina/patología , Edad GestacionalRESUMEN
PURPOSE: To define diagnostic morphometric parameters of central fundus and peripheral retinal vessels that characterize different types of retinopathy of prematurity (ROP) course. MATERIAL AND METHODS: A total of 155 premature infants (310 eyes) with stage I, II, and III ROP were assessed as they were undergoing treatment in the Kaluga branch of "Eye Microsurgery" complex during 2010-2012. Patients with the same stage of the disease were divided into two groups according to the type of ROP course (type 1--ROP with low risk of progression, type 2--ROP with high risk of progression). Original ROP-MORPHOMETRY software was used for morphometric analysis of digital images of the fundus taken with RetCam 120 and RetCam 3 through a 130 degree lens. RESULTS: Regardless the stage of the disease, larger diameter of retinal vessels and higher tortuosity index was found in type 2 ROP (favorable) as compared with type 1 ROP (unfavorable). An observation was made, that the father from the central fundus the narrower became the vessels of both nasal and temporal arcades. CONCLUSION: The obtained quantitative morphometric data can help to clearly determine the risk of progression at any stage of ROP.
Asunto(s)
Retina , Vasos Retinianos , Retinopatía de la Prematuridad , Investigación sobre la Eficacia Comparativa , Técnicas de Diagnóstico Oftalmológico , Progresión de la Enfermedad , Femenino , Fondo de Ojo , Edad Gestacional , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Recién Nacido , Recien Nacido Prematuro , Masculino , Gravedad del Paciente , Pronóstico , Retina/patología , Retina/fisiopatología , Vasos Retinianos/patología , Vasos Retinianos/fisiopatología , Retinopatía de la Prematuridad/diagnóstico , Retinopatía de la Prematuridad/fisiopatologíaRESUMEN
Dynamic evaluation of the diameters of central fundus vessels, 2nd order and peripheral vessels as well as the tortuosity index of central zone arteries in stage II and III retinopathy of prematurity (ROP), which showed regression after laser treatment, was performed. Obtained data can be used for estimation of the optimal follow-up period ensuring early detection of high probability for ROP progression after laser coagulation and decrease of the number of diagnostic examinations for patients whose pathologic process is resolving.
Asunto(s)
Fotocoagulación , Arteria Retiniana , Retinopatía de la Prematuridad , Técnicas de Diagnóstico Oftalmológico , Progresión de la Enfermedad , Diagnóstico Precoz , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Recién Nacido , Fotocoagulación/métodos , Fotocoagulación/estadística & datos numéricos , Masculino , Pronóstico , Arteria Retiniana/patología , Arteria Retiniana/fisiopatología , Retinopatía de la Prematuridad/diagnóstico , Retinopatía de la Prematuridad/fisiopatología , Retinopatía de la Prematuridad/terapia , Índice de Severidad de la Enfermedad , Resultado del TratamientoRESUMEN
75 clinical cases of acute impairment of cerebral circulation treated with sinusoidal modulated currents in combination with transcerebral magnetic field have been analysed. Functional and clinical findings indicate that the above combination is much more effective than magnetic field and sinusoidal modulated currents alone: 62% against 35% and 33%, respectively.