Experience of Various Types of Keratoplasty in Children

The purpose: to determine the features of different stages of active retinopathy prematurely according to fluorescent angiography data.

Patients and methods. In 2011–2017, 271 angiographic studies were performed in 207 premature infants born at 25–33 weeks of gestation with 710–1980 grams weight at birth, with different stages of active ROP in age of live 3–12 weeks (30-39 weeks of post-conceptual age). A voluntary informed consent to perform the examination was received from the legal representatives of all patients. FAG was performed using retinal pediatric digital video system “RetCam-3” with built-in angiographic unit under mask anesthesia, in the presence of anesthesiologist-resuscitator, under the monitor control of the respiratory and cardiovascular systems of the child.

Results. Unfavorable types of active ROP are characterized by the specific manifestations that are not defined by the standard ophthalmologic methods: early flat neovascularization, the presence of small tortuous peripheral vessels with signs of leakage, reperfusion areas with an apparent lack of capillaries and shunts. This opens up the opportunities for early detection of stages of the disease requiring therapeutic measures. The aggressive posterior ROP is distinguished by a variety of angiographic patterns, the most important feature is the massive loss of the retinal capillary bed in the vascularized retina. FAG data about latent neovascularization and ischemic zones of the retina represent the particular value in the prediction of active ROP course.

Conclusion. The obtained results could allow to make the most differentiated approach to the management of children with active ROP, timely and effectively predict the course of the disease and to performed adequate treatment based on objective indications. 

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