Mathematical substantiation of the optimized method of retinal pattern laser coagulation using the hexagonal pattern form in the treatment of active stages of retinopathy of prematurity

2019 ◽  
pp. 422-425
Author(s):  
Y.A. Sidorova ◽  
◽  
A.V. Tereshchenko ◽  
I.G. Trifanenkova ◽  
V.V. Firsova ◽  
...  
Keyword(s):  
Retinopathy Of Prematurity ◽  
Laser Coagulation ◽  
Hexagonal Pattern

The first experience of application of vessel endothelium growth factor inhibitor ranibizumab in complex therapy of retinopathy of premature in URFO in SAHI of the Sverdlovsk region MСMC «Bonum»

2021 ◽  
pp. 360-362
Author(s):  
M.A. Kariakin ◽  
◽  
E.A. Stepanova ◽  
S.A. Korotkikh ◽  
N.S. Timofeeva ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Intravitreal Injection ◽  
Laser Treatment ◽  
Retinopathy Of Prematurity ◽  
Laser Coagulation ◽  
Complete Regression ◽  
Complex Treatment ◽  
Partial Regression ◽  
Factor Inhibitor ◽  
Retinal Adhesion

Material and methods. The study included 16 patients (31 eyes). Types and terms of treatment. Stage I in the treatment of ROP, laser coagulation of the avascular areas of the retina was performed in three patients with aggressive posterior ROP (4 eyes, 12.9%). In all patients, the progression of the disease was noted. Intravitreal injection of ranibizumab was performed in the period from 8 to 16 weeks (10.5±2.0 weeks), PCV from 32.3 to 39.6 weeks (37.0±1.8 weeks). Result. After laser treatment and IVI of ranibizumab, 11 patients (31 eyes, 81.6%) showed regression of the disease. In 5 patients (6 eyes, 19.4%) - progression. If the ROP progressed, a 25G or 27G lenssparing vitrectomy was performed. Complete regression of ROP was achieved in one patient (1 eye, 16.7%). Partial regression was observed in two patients (2 eyes, 33.3%). In two patients (3 eyes, 50%), the disease progressed to stage 5 with the development of total retinal detachment. Conclusion. As a result of the complex treatment of severe forms of the active stage of retinopathy of prematurity in the regional children's ophthalmological center MKMC "Bonum" in Yekaterinburg, the following data were obtained: complete regression with retinal adhesion is observed in 12 patients (26 eyes, 83.4%), of which in one patient (1 eye, 3.2%) regression was achieved after vitrectomy. Partial regression with the formation of a peripheral retinal detachment after vitrectomy was achieved in two patients (two eyes - 6.5%). Progression of retinopathy of prematurity to stage V with the development of total retinal detachment in two patients (3 eyes, 9.6%). Complex treatment of severe stages of active ROP using laser treatment, IVI and vitrectomy allows to preserve vision in 90.4% of patients. Key words: retinopathy of prematurity; intravitreal injection; laser coagulation of the retina; vitrectomy.

scholarly journals Visual Functions in Children in Remote Postoperative Period after Laser Treatment of Threshold Stages of Retinopathy of Prematurity

2018 ◽  
Vol 15 (2S) ◽  
pp. 18-23
Author(s):  
M. V. Pshenichnov ◽  
O. V. Kolenko ◽  
V. V. Egorov ◽  
E. L. Sorokin
Keyword(s):  
Visual Acuity ◽  
Postoperative Period ◽  
Retinopathy Of Prematurity ◽  
Vision Loss ◽  
State Institution ◽  
Laser Coagulation ◽  
Visual Functions ◽  
Functional Changes ◽  
Continuous Sampling ◽  
High Degree

Purpose.Analysis of visual functions in children in remote postoperative period after laser coagulation (LC) of threshold stages of retinopathy of prematurity (ROP).Patients and methods. In 2017, we selected and investigated 18 children, who previously had an LC of threshold stages of ROP in 2008–2009 in the Khabarovsk branch of the S.N. Fyodorov State Institution Eye Microsurgery Complex (continuous sampling method). There were 5 boys and 13 girls aged from 8 to 9 years at the time of LC. Anterior and posterior eye segments of the eyes (biomicroscopy, ophthalmoscopy), visual acuity, clinical refraction, concomitant pathology were evaluated.Results. We have revealed that regressive ROP after LC is characterized by the presence of serious anatomical and functional changes in the eyes. First, these are refractive disorders, which revealed in 90.5% of cases. Most often revealed: myopic refraction — 61% of all cases, of which more than half (53%) is its high degree; or its combination with compound myopic astigmatism (77% eyes); anisometropia was detected in 39% children. These refractive disorders led to the development of strabismus (61% children) and mixed amblyopia (60%). Despite the combined ophthalmologic pathology, 17% children developed visual functions with achievement of binocular vision, in most children visual functions still continue to develop, although they are not high due to amblyopia. High visual acuity (from 0.8 and above) in both eyes was formed in 22% children; visual acuity in the range of 0.5–0.7 in both eyes was formed in 17% children. Unfortunately, 44.5% children at the time of examination had low visual functions (in the range of 0.05–0.4) in both eyes. Extremely low visual acuity (from 0.01 to 0.04) in both eyes was identified in 11% children; absolute blindness in one of the eyes was in 11% children.Conclusions. LC is reliable way to prevent vision loss from retinal detachment in children with threshold stages of ROP. 

Аnatomical and functional features of eyes in children with the second stage of cicatricial retinopathy of prematurity after laser coagulation

2021 ◽  
pp. 39-42
Author(s):  
M.V. Pshenichnov ◽  
◽  
O.V. Kolenko ◽  
◽  
Keyword(s):  
Evoked Potentials ◽  
Anterior Chamber ◽  
Visual Evoked Potentials ◽  
Retinopathy Of Prematurity ◽  
Retinal Thickness ◽  
Main Group ◽  
Laser Coagulation ◽  
Macular Area ◽  
Functional Features ◽  
Visual Evoked

Purpose. To evaluate anatomical and functional features of eyes in children with the 2nd stage of cicatricial retinopathy of prematurity (ROP) in long-term period after underwent laser coagulation (LC) of threshold stages of ROP. Material and methods. 18 children with the 2nd stage of cicatricial ROP, who in 2008–2009 underwent LC of retina of threshold stages of ROP (the main group). Selection criterion is absence of traction changes in macular area. In patients aged 8–9 years we studied visual evoked potentials (VEP), performed optical coherence tomography in macular area, and ocular biometry. The control was healthy children of similar age. Results. In the main group we revealed: statistically significant differences in increase of foveal thickness; tendency to reduction of retinal thickness in all segments of macular area; in 89% of cases pathological changes were observed in VEP, despite visually intact optic disc and macula. Conclusion. The features of eyes in children with 2nd stage of cicatricial ROP who underwent LC of retina of threshold stages of ROP, were: increase retinal thickness in fovea, uniform decrease in retinal thickness in other sectors in macular area, more smaller anterior chamber of the eye and narrow anterior chamber angle, than healthy peers. Key words: cicatricial retinopathy of prematurity, retinal thickness, anterior chamber of the eye, visual evoked potentials.

scholarly journals New opportunities in management of patients with retinopathy prematurity (literature review and analysis of own data)

2020 ◽  
Vol 13 (4) ◽  
pp. 70-74
Author(s):  
L. A. Katargina ◽  
E. N. Demchenko
Keyword(s):  
Retinopathy Of Prematurity ◽  
Randomized Study ◽  
Clinical Effectiveness ◽  
Posterior Pole ◽  
Peripheral Retina ◽  
Laser Coagulation ◽  
Type I ◽  
Degree Relative ◽  
Anti Vegf ◽  
Increased Risk

Insufficient effectiveness of laser coagulation of the avascular retinal areas in retinopathy of prematurity (ROP) plus-disease in zone I and aggressive posterior retinopathy of prematurity (APROP) requires new treatment approaches, based on the regulation of retinal angiogenesis and anti-VEGF drugs use. The BEAT-RAP study, which was the first major randomized study of anti-VEGF therapy in ROP, revealed a higher effectiveness of bevacizumab compared to retinal laser coagulation in stage 3 plus-disease of zone I. A prospective randomized trial, RAINBOW, demonstrated the effectiveness of ranibizumab in plus-disease stages 1, 2 and 3 in zone I and stage 3 in zone II and in APROP, so that the drug may be recommended for use in children with ROP. The demonstrated high effect of anti-VEGF therapy in ROP is consistent with our own data. Anti-VEGF therapy opens up new possibilities in the treatment of a particular class of ROP forms. The advantages of anti-VEGF therapy include higher clinical effectiveness of treatment of ROP type I with localization in the posterior pole (I and posterior II zone), absence of "blockage" of the peripheral retina, lower frequency of myopia development and degree, relative fastness of the procedure, the acceptability for patients whose fundus is difficult to visualize, and somatically burdened patients who are contraindicated for prolonged anesthesia used for retinal laser coagulation. When using anti-VEGF drugs in the post-threshold stages of the disease, one should take account of an increased risk of proliferation progression and retinal detachment development. Premature infants with retinopathy regression after anti-VEGF therapy require a longer duration of regular and frequent follow-up (up to 70 weeks of postmenstrual age) due to the risk of relapse and extraretinal proliferation in future.

scholarly journals Clinical Course and Results of Anti-VEGF Therapy of Retinopathy of Prematurity

2021 ◽  
Vol 18 (1) ◽  
pp. 136-142
Author(s):  
L. A. Katargina ◽  
E. N. Demchenko ◽  
L. V. Kogoleva
Keyword(s):  
Retinopathy Of Prematurity ◽  
Functional Outcomes ◽  
Clinical Course ◽  
Repeated Administration ◽  
Additional Treatment ◽  
Research Centre ◽  
Peripheral Retina ◽  
Laser Coagulation ◽  
Anti Vegf

The clinical course of active retinopathy after anti-VEGF therapy, the possibility and timing of recurrence of the disease, anatomical and functional outcomes of treatment are widely discussed in the press, not fully studied and relevant.Purpose: to study the clinical course of active retinopathy of prematurity after anti-VEGF therapy and clinical and functional outcomes.Patients and Methods. Children with active retinopathy of prematurity, who turned to the Helmgoltz National Medical Research Centre of Eye Diseases after anti-VEGF therapy, examined by indirect binocular ophthalmoscopy and digital retinal camera (RetcamShuttle). Children were monitored from 1.5 to 6 years (average 2.94 ± 1.47). All children underwent routine examination, 4 children older than 3 years underwent optical coherence tomography.Results. In all cases, after anti-VEGF therapy, there was a decrease in vascular activity and continued vascularization of the retina. Recurrence of the disease requiring additional treatment, were detected in 11 (42.3 %) eyes within 6–22 weeks (in average 13.33 ± 5.57) after intravitreal anti-VEGF therapy. Laser coagulation of the retina was carried out in 4 children (7 eyes) and repeated administration of anti-VEGF drug — 2 children (4 eyes), which led to regression of the disease. In the long-term period, all 13 (100 %) children had successful outcomes.Conclusion. Anti-VEGF therapy is effective in plus-zone 1 disease and posterior aggressive retinopathy of prematurity. Its advantages include the ability to treat retinopathy in zone 1 posterior, the absence of “blockade” of the peripheral retina with the possibility of continued growth of blood vessels to the periphery, lower frequency and severity of myopia. The disadvantages include the possibility of recurrence of the disease, which requires long-term regular monitoring.

Study of the effectiveness of transpupillary hexagonal pattern retinal laser coagulation in the treatment of active ROP stages

2020 ◽  
pp. 143-144
Author(s):  
V.V. Firsova ◽  
◽  
A.V. Tereshchenko ◽  
I.G. Trifanenkova ◽  
Y.A. Sidorova ◽  
...  
Keyword(s):  
Laser Coagulation ◽  
Hexagonal Pattern

Цель. Изучить эффективность гексагональной паттерновой лазеркоагуляции сетчатки (ЛКС) при активной ретинопатии недоношенных (РН) в сравнении с матричной паттерновой ЛКС. Материал и методы. С 2017 по 2019 гг. в Калужском филиале МНТК транспупиллярная ЛКС была проведена у 142-х младенцев (161 глаз) с активными стадиями РН. Всем пациентам лазерное лечение проводилось на паттерновой системе «Integrе Pro Scan» 561 нм (Ellex, Австралия). В основной группе выполняли ЛКС с использованием паттерна гексагональной формы (суммарно 7 аппликатов) – 69 детей. В контрольной группе ЛКС проводили с использованием матричных паттернов 3*3 (суммарно 9 аппликатов) – 73 младенца. Межспотовое расстояние в основной группе было увеличено на 0,25 диаметра коагулята по сравнению с контрольной. Результаты. Гексагональная паттерновая ЛКС обеспечила регресс заболевания при 3-«пороговой» стадии на 112 глазах (97%), при задней агрессивной РН на стадии ранних клинических проявлений – на 10 глазах (86%), на стадии манифестации – на 6 глазах (75%). Регресс заболевания при проведении стандартной паттерновой ЛКС с использованием квадратной матричной решетки на 3-«пороговой» стадии был отмечен на 109 глазах (96%), при задней агрессивной РН на стадии ранних клинических проявлений – на 8 глазах (80%), на стадии манифестации – на 4 глазах (66,7%). Длительность лазерного лечения, суммарная энергетическая нагрузка, частота использования одиночных импульсов в основной группе были значительно меньше, чем в контрольной. Заключение. Гексагональная паттерновая ЛКС обеспечивает высокую эффективность лазерного лечения активной РН и позволяет сократить продолжительность сеанса лечения по сравнению с матричной паттерновой ЛКС. Уменьшение плотности гексагональной ЛКС по сравнению с матричной приводит к уменьшению суммарной энергетической нагрузки на сетчатку глаза недоношенного ребенка с сохранением высокой клинической эффективности метода.

Systematic review and meta-analysis of the negative outcomes of retinopathy of prematurity treated with laser photocoagulation

2018 ◽  
Vol 29 (2) ◽  
pp. 223-228 ◽  
Author(s):  
Jing Liang
Keyword(s):  
Confidence Interval ◽  
Laser Treatment ◽  
Retinopathy Of Prematurity ◽  
Odds Ratio ◽  
Laser Photocoagulation ◽  
Meta Analysis ◽  
Anterior Chamber Depth ◽  
Mean Difference ◽  
Laser Coagulation ◽  
Spherical Equivalent

Introduction: Retinopathy of prematurity is a leading cause of potentially avertable childhood blindness around the world. And laser photocoagulation is currently performed as a gold standard for retinopathy of prematurity treatment, but it may contribute to elevated myopia and decreased visual field. Therefore, the objective of this meta-analysis is to explore the negative impact of laser photocoagulation for retinopathy of prematurity in terms of anatomic outcomes and structural outcomes. Methods: Studies were retrieved through literature searches in PubMed and EMBASE from 1990 to 2017 in English. Case-control studies that reported anatomic and structural changes or significant complications after laser coagulation or cryotherapy for retinopathy of prematurity were eligible. Results: This meta-analysis included eight original studies related to laser treatment for retinopathy of prematurity at any stages. A total of 1422 infants were participated, of which 1156 documented subthreshold or threshold retinopathy of prematurity without laser treatment were selected as comparison group and the rest treated with diode or argon laser coagulation were chosen for experiment group. Taking all included studies into account, spherical equivalent (mean difference −2.53, 95% confidence interval: –5.23 to 0.18, I2 = 96%, P < 0.00001), anterior chamber depth (mean difference −0.52, 95% confidence interval: −0.76 to −0.28, I2 = 55%, P = 0.11), astigmatism (odds ratio 3.19, 95% confidence interval: 1.61 to 6.32, I2 = 0%, P = 0.54), and myopia (odds ratio 8.08, 95% confidence interval: 3.79 to 17.23, I2 = 37%, P = 0.21) were associated with laser treatment for retinopathy of prematurity. Axial length (mean difference −0.01, 95% confidence interval: –0.28 to 0.27, I2 = 0%, P = 0.62) and anisometropia (odds ratio 4.21, 95% confidence interval: 0.54 to 33.17, I2 = 1%, P = 0.31) had no statistical significance on laser coagulation for retinopathy of prematurity. Conclusion: This meta-analysis showed that spherical equivalent, anterior chamber depth, astigmatism, and myopia were associated with the negative outcomes of laser coagulation, while axial length and anisometropia had no statistical importance on the defects of laser coagulation. Therefore, patients treated with laser coagulation should follow periodic cycloplegic refraction and receive early optical correction.

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