ophthalmologyОфтальмологияOphthalmology in Russia1816-50952500-0845Ophthalmology10.18008/1816-5095-2021-1-136-142ophthalmology-1447Research ArticleОФТАЛЬМОФАРМАКОЛОГИЯPHARMACOLOGYОсобенности клинического течения активной ретинопатии недоношенных и результаты анти-VEGF терапииClinical Course and Results of Anti-VEGF Therapy of Retinopathy of Prematurityhttps://orcid.org/0000-0002-4857-0374КатаргинаЛ. А.KatarginaL. A.

Катаргина Людмила Анатольевна — доктор медицинских наук, профессор, заместитель директора по научной работе

ул. Садовая-Черногрязская, 14/19, Москва, 105062

Katargina Ludmila A. — MD, Professor, deputy director

Sadovaya-Chernogryazskaya str., 14/19, Moscow, 105062

https://orcid.org/0000-0001-6523-5191ДемченкоЕ. Н.DemchenkoE. N.

Демченко Елена Николаевна кандидат медицинских наук, научный сотрудник отдела патологии глаз у детей

ул. Садовая-Черногрязская, 14/19, Москва, 105062

Demchenko Elena N. — PhD, researcher of the Department of children’s ocular pathology

Sadovaya-Chernogryazskaya str., 14/19, Moscow, 105062

https://orcid.org/0000-0002-2768-0443КоголеваЛ. В.KogolevaL. V.

Коголева Людмила Викторовна — доктор медицинских наук, заведующая детским консультативным поликлиническим отделением

Kogoleva Ludmila V. — MD, head of the Children's advisory polyclinic department

Sadovaya-Chernogryazskaya str., 14/19, Moscow, 105062

Kogoleva@mail.ruФГБУ «Научный медицинский исследовательский центр глазных болезней имени Гельмгольца»РоссияHelmgoltz National Medical Research Centre of Eye DiseasesRussian Federation202104042021181136142Copyright © Катаргина Л.А., Демченко Е.Н., Коголева Л.В., 20212021Катаргина Л.А., Демченко Е.Н., Коголева Л.В.Katargina L.A., Demchenko E.N., Kogoleva L.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.ophthalmojournal.com/opht/article/view/1447

Клиническое течение активной ретинопатии после анти-VEGF терапии, возможность и сроки развития рецидивов заболевания, анатомические и функциональные исходы широко обсуждаются в печати, окончательно не изучены и актуальны.

Цель исследования

Цель исследования: изучить клинические особенности течения активной ретинопатии недоношенных после анти-VEGF терапии и клиникофункциональные исходы.

Пациенты и методы

Пациенты и методы. Дети с активной ретинопатией недоношенных, обратившиеся в кабинет недоношенного ребенка после проведения анти-VEGF терапии, обследованы при помощи непрямой бинокулярной офтальмоскопии и на цифровой ретинальной камере. Дети находились под наблюдением от 1,5 до 6 лет (в среднем 2,94 ± 1,47 года). Всем детям выполнено рутинное обследование, 4 детям старше 3 лет проведена оптическая когерентная томография.

Результаты

Результаты. Во всех случаях после анти-VEGF терапии отмечено уменьшение сосудистой активности и продолженная васкуляризация сетчатки. Рецидивы заболевания, потребовавшие проведения дополнительного лечения, выявлены на 11 (42,3 %) глазах в сроки 6–22 недели (13,33 ± 5,57) после введения анти-VEGF препарата. Лазеркоагуляция сетчатки выполнена у 4 детей (7 глаз) и повторное введение анти-VEGF препарата у 2 детей (4 глаза), что привело к регрессу заболевания. В отдаленном периоде у всех 13 (100 %) детей отмечены благополучные исходы.

Заключение

Заключение. При плюс-болезни 1-й зоны и задней агрессивной ретинопатии недоношенных анти-VEGF терапия эффективна. К ее достоинствам относятся возможность лечения ретинопатии при ее локализации в задней части 1-й зоны, отсутствие «блокады» периферической сетчатки с возможностью продолжения роста сосудов на периферию, меньшая частота и степень миопии. К недостаткам следует отнести возможность развития рецидивов заболевания, что требует длительного регулярного мониторинга.

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

Purpose: to study the clinical course of active retinopathy of prematurity after anti-VEGF therapy and clinical and functional outcomes.

Patients and Methods

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

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

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.

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The authors declare that there are no conflicts of interest present.