Early Vitreous Surgery in the Treatment of Aggressive Posterior Retinopathy of Prematurity

The goal is to identify objective indications for early primary vitreous surgery in infants with aggressive posterior ROP and to develop a methodology. Patients and methods. The study included 20 preterm infants (40 eyes) with aggressive posterior ROP at the stage of formation exudative-tractional retinal detachment, which were divided into two groups. The main group consisted of 10 infants (20 eyes) with severe manifestations of aggressive posterior ROP. The control group included 10 premature infants (20 eyes) with aggressive posterior ROP, who underwent transpupillary laser coagulation of the retina (LC). In all cases (20 eyes) 5-8 days after LC was recorded the progression of the disease. Based on data from a complex ophthalmic examination, given the progression of the disease after LC in the control group and baseline severe aggressive posterior ROP in the main group with the control with identical clinical picture, patients in both groups was made early vitreous surgery: in the main group — after ophthalmological examination and control after 8-16 days after LC. Results. In the main group after 6 months in 15 eyes (75%) formed the correct vitreomacular interface, in 5 cases (25%) were diagnosed with the smoothness of the foveolar pits by sealing the internal limiting membrane with no signs of retinal edema. In the control group after 6 months in 6 eyes (30%) formed the right macular interface in 11 (55%) — was defined by flatness or lack foveolar pit with no signs of retinal edema. On 3 eyes (15%) in the 2nd zone remained a local retinal detachment. 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. It is an alternative and pathogenetically substantiated technology, which efficiency is not inferior to the traditional approach, including LС followed by vitreous surgery.

aggressive posterior retinopathy of prematurity, progression of disease, laser coagulation of the retina, primary vitreous surgery

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