Vitrectomy as an independent method of treatment of aggressive posterior retinopathy of prematurity

    Abstract

    

    Vitrectomy as an independent method of treatment of aggressive posterior retinopathy of prematurity

    

    A.V. Tereshchenko, J.A. Belyi, J.A. Sidorova, I.G. Trifanenkova, M.S. Tereshchenkova, E.V. Erohina, S.V. Isaev

    

    The Kaluga Branch of the S. Fyodorov Eye Microsurgery Federal State Institution, Kaluga, Russia

    

    Purpose.To identify objective indications for early primary vitreous surgery in infants with aggressive posterior retinopathy of prematurity (ROP) and to develop its methodology.

    Material and methods.The study included 20 preterm infants (40 eyes) with aggressive posterior ROP at the stage of exudativetractional retinal detachment formation. The main group: 10 infants (20 eyes) with severe manifestations of aggressive posterior ROP. The control group: 10 premature infants (20 eyes) with aggressive posterior ROP, who underwent the transpupillary laser coagulation of the retina (LC). In all cases (20 eyes) a progression of the disease was recorded at 5-8 day after the LC. Based on data of a complex ophthalmic examination, confirming the progression of the disease after the LC in the control group and the baseline of severe aggressive posterior ROP in the main group with identical clinical picture with the control, the early vitreous surgery was performed in patients of both groups: in the main group – after ophthalmological examination and in the control 8-16 days after the LC.

    Results.In the main group a correct vitreo-macular interface was formed 6 months later in 15 eyes (75%), a smoothness of the fovea due to a thickening of the internal limiting membrane without signs of retinal edema was diagnosed in 5 cases (25%). In the control group a correct macular interface was formed after 6 months in 6 eyes (30%), a smoothness of the fovea or its lack without signs of retinal edema was defined in 11 eyes (55%). In 3 eyes a local retinal detachment remained (15%) in the 2nd zone.

    Conclusion.Primary vitrectomy performed according to the developed indications, allows to optimize the treatment of patients with aggressive posterior ROP in cases of inefficiency of the LC.

    Key words: aggressive posterior retinopathy of prematurity, progression of disease, laser coagulation of the retina, primary vitreous surgery.