Russian Pediatric OphthalmologyRussian Pediatric OphthalmologyРоссийская педиатрическая офтальмология1993-18592412-432XEco-Vector7095710.17816/rpoj70957Original study articleОригинальные исследованияResearch ArticleTreatment outcomes of central retinopathy of prematurity with localization in the Moscow regional perinatal centerРезультаты лечения ретинопатии недоношенных центральной локализации в Московском областном перинатальном центреhttps://orcid.org/0000-0003-2103-15709930-4813PanovaA. Y.ПановаА. Ю.
Russian Federation

MD, PhD

кандидат медицинских наук

annie_panova18@mail.ruhttps://orcid.org/0000-0002-8020-2598PetrovaA. S.ПетроваА. С.
Russian Federation

MD, PhD

кандидат медицинских наук

as.petrova@icloud.comhttps://orcid.org/0000-0001-6582-9571TrusovaS. A.ТрусоваС. А.
Russian Federation

neonatologist

врач-неонатолог

svetlana28122@yandex.ruhttps://orcid.org/0000-0002-3948-0270ShevernayaO. A.ШевернаяО. А.
Russian Federation

ophthalmologist

врач-офтальмолог

shevernaya.olga@mail.ruHelmholtz National Medical Research Center of Eye DiseasesНМИЦ глазных болезней им. ГельмгольцаMoscow Regional Perinatal CenterМосковский областной перинатальный центр2312202116319262505202102092021Copyright ©; 2021, Eco-VectorCopyright ©; 2021, ООО "Эко-Вектор"2021Eco-VectorООО "Эко-Вектор"https://ruspoj.com/1993-1859/article/view/70957

BACKGROUND: Ranibizumab is widely used in retinopathy of prematurity. Therefore, it is necessary to evaluate the effectiveness, the risk of complications, and recurrence of the disease by antiangiogenic therapy.

AIM: To demonstrate the experience of using anti-VEGF drugs in the Moscow Regional Perinatal Center and the effectiveness of different approaches to retinopathy of prematurity (ROP) treatment in the central retinal zone.

MATERIAL AND METHODS: The case histories of 17 deeply premature infants with threshold ROP stages and localization in the posterior pole were retrospectively analyzed. Children were treated with intravitreal VEGF inhibitor (total 9 children), 5 children underwent laser coagulation of the retina, and 3 children received combined treatment (laser and intravitreal administration of a VEGF inhibitor).

RESULTS: The average age of development of threshold stages was 35.2 weeks (range: 30.5–39 weeks) in our study. The frequency of promising outcomes after using anti-VEGF drugs alone or in conjunction with peripheral laser treatment was 100%. In comparison, the only laser treatment generated a promising result in 70% of the eyes. However, ROP relapses after anti-VEGF therapy developed at 37, 43, 44,5 weeks. In addition, 1 out of 9 children developed a recurrence of ROP and required laser treatment 7 weeks after using anti-VEGF.

CONCLUSION: The use of anti-VEGF therapy is an effective method for the treatment of ROP of the posterior pole. However, there is the ambiguity of the available recommendations on the further management of children. Therefore, it is necessary to monitor the children who have received antiangiogenic therapy for as long as possible.

Введение. Учитывая регистрацию ранибизумаба для применения при ретинопатии недоношенных, необходимо оценить эффективность и риск возможных осложнений и рецидива заболевания при использовании антиангиогенной терапии.

Цель. Продемонстрировать опыт применения анти-VEGF препаратов в ГБУЗ Московской области «Московский областной перинатальный центр» (МОПЦ) и оценить эффективность различных подходов к лечению ретинопатии недоношенных (РН) центральной зоны сетчатки.

Материал и методы. Ретроспективно проанализированы истории болезни 17 глубоконедоношенных детей с пороговыми стадиями ретинопатии и локализацией в заднем полюсе. Дети направлялись на интравитреальное введение ингибитора VEGF (9 детей). Части детей была выполнена лазеркоагуляция сетчатки в полном объёме (5 детей), у трёх детей применялось комбинированное лечение (лазеркоагуляция и интравитреальное введение ингибитора VEGF).

Результаты. Средний возраст развития пороговых стадий в нашем исследовании составил 35,2 недель (от 30,5 до 39 недель). Частота благоприятных исходов после применения анти-VEGF препаратов изолированно или совместно с периферической лазеркоагуляцией (ЛК) составила 100%, тогда как после проведения только ЛК — 70% глаз. Рецидивы РН после применения анти-VEGF терапии развились на 37-й, 43-й и на 44,5-й неделе постконцептуального возраста (ПКВ). У одного из 9 детей через 7 недель после применения анти-VEGF развился рецидив РН, потребовавший проведения ЛК сетчатки.

Заключение. Применение анти-VEGF терапии является эффективным методом лечения РН заднего полюса. Неоднозначность имеющихся рекомендаций по дальнейшему ведению детей, получивших антиангиогенную терапию, делает необходимым максимально внимательное и длительное наблюдение за такими детьми.

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