Crucial fluorescent angiographic features of favorable and unfavorable course of active retinopathy of prematurity

Abstract

Purpose. To determine the crucial fluorescence-angiographic features of favorable and unfavorable types of active retinopathy of prematurity and evaluate their prognostic informational value. Material and methods. Fundus fluorescence angiography (FFA) was performed by 180 premature infants (180 eyes). The children had 1st–3rd stage of active ROP. The age of gestation of the children was 24–34 weeks. A birth weight of the children was 560–2150 g. By the time of the study the age of the children was 3–14 weeks. This age corresponded to 30–38 weeks of postconceptual age (PCA). The stage and type of the pathological process was determined by using a comprehensive ophthalmological examination, which included reverse ophthalmoscopy, digital retinoscopy and morphometry. Children were admitted to FFA procedure in a stable somatic state, without pathology of renal and hepatic metabolism, after setting a test to determine the sensitivity to the drug. The evaluation of the prognostic information content of the revealed features of FFA in relation to the type of disease course was performed. Statistical processing of the research results was carried out by using the Statistica 13.3 program (Tibco Software Inc., USA). Results. During of the study, pathological fluorescence-angiographic features were identified and studied. These features were conditionally divided into 3 groups depending on the location on the fundus: near the border with the avascular retina, in the avascular retina, in the vascularized retina. It has been shown that the unfavorable course of the 1st–3rd stage of active ROP is distinguished by a much wider variety of fluorescence-angiographic phenomena and their more pronounced intensity (frequency of occurrence) in comparison with the favorable course of active ROP. On the basis of a comprehensive statistical analysis, the most informative fluorescence-angiographic features for the prognosis of the type of active ROP were determined: increased vascular tortuosity near the border with the avascular retina, zones of capillary nonperfusion in the vascularized retina, multiple foci of local neovascularization in the vascularized retina. Conclusion. Clinical use of a fluorescence angiographic study of the fundus of patients with ROP with the determination of crucial prognostic features of favorable and unfavorable types in the early stages of the disease will contribute to early treatment of this severe retinal pathology in premature infants and consequently, its favorable outcome. Key words: fluorescence angiography, retinopathy of prematurity, prognosis