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Premature newborns have a high risk of developing visual impairments. This study presents the experience of an organization dispensary ophthalmological observation as a stage of providing medical care to premature children in St. Petersburg and the prospects for its development. AIM: To analyze the effectiveness of the organizational model of dispensary ophthalmological observation of premature children in St. Petersburg for 20202022. MATERIAL AND METHODS: Reporting forms of the activities of interdistrict ophthalmological cabinet and reporting forms of medical and social expertise of Rosstat No. 7D were used. RESULTS: In 2010, a system of specialized ophthalmological care for premature infants at the hospital stage was organized in St. Petersburg (screening and laser treatment of active ROP using telemedicine technologies; surgical treatment of late disease stages). In 2018, for the subsequent dispensary observation of premature children aged up to 3 years, six inter-district ophthalmological cabinets of follow-up were organized. A developed routing scheme for children at risk and with active and cicatricial ROP in St. Petersburg and preliminary results of ROP incidence were presented. CONCLUSION: The activities of specialized inter-district follow-up cabinets primarily ensure continuity between hospital and outpatient services in the dynamic monitoring of children at risk and children with active ROP. In addition, professional competencies allow ophthalmologists to avoid mistakes in diagnosing the stage, monitoring the ROP course, and promptly referring patients for emergency treatment (laser or anti-VEGF therapy).
Premature newborns have a high risk of developing visual impairments. This study presents the experience of an organization dispensary ophthalmological observation as a stage of providing medical care to premature children in St. Petersburg and the prospects for its development. AIM: To analyze the effectiveness of the organizational model of dispensary ophthalmological observation of premature children in St. Petersburg for 20202022. MATERIAL AND METHODS: Reporting forms of the activities of interdistrict ophthalmological cabinet and reporting forms of medical and social expertise of Rosstat No. 7D were used. RESULTS: In 2010, a system of specialized ophthalmological care for premature infants at the hospital stage was organized in St. Petersburg (screening and laser treatment of active ROP using telemedicine technologies; surgical treatment of late disease stages). In 2018, for the subsequent dispensary observation of premature children aged up to 3 years, six inter-district ophthalmological cabinets of follow-up were organized. A developed routing scheme for children at risk and with active and cicatricial ROP in St. Petersburg and preliminary results of ROP incidence were presented. CONCLUSION: The activities of specialized inter-district follow-up cabinets primarily ensure continuity between hospital and outpatient services in the dynamic monitoring of children at risk and children with active ROP. In addition, professional competencies allow ophthalmologists to avoid mistakes in diagnosing the stage, monitoring the ROP course, and promptly referring patients for emergency treatment (laser or anti-VEGF therapy).
Purpose: to assess the organizational effectiveness of ophthalmic observation of premature infants in pediatric follow-up in St. Petersburg. Material and methods. We analyzed the reports submitted by city interdistrict ophthalmological facilities for retinopathy of prematurity (ROP) and the observation department for premature infants for the period from July 1, 2018 to July 1, 2021 available at the children's multidisciplinary hospital. Results. In St. Petersburg, 6 interdistrict ophthalmological facilities perform regular monitoring of ROP children and a daytime in-patient clinic offers interdisciplinary treatment and early rehabilitation of infants with perinatal pathology accompanying severe prematurity. The data on the frequency of ROP and other visual disorders in children born prematurely are presented. Conclusions. Interdistrict observation facilities are a modern form of regular ophthalmic follow-up of premature infants of risk groups or ROP infants who live in conditions of a large city. A promising observation model of children with combined perinatal pathology and severe prematurity is the setting of a department (daytime in-patient facility) in the children's multidisciplinary hospital. This allows assessing the general health of this critical group of population" and ensure a timely start of combined interdisciplinary treatment and medical rehabilitation.
The improvement in nursing routine of premature babies with low and extremely low body weight has increased their survival rate. Along with the growing number of such children, retinopathy of prematurity (ROP) occurs relatively less often and its outcome becomes more favorable. Modern approaches to the surgical treatment have led to a significant reduction in the incidence of blindness and visual disability caused by ROP. Yet, ROP remains one of the major issues in neonatal ophthalmology, often associated with refractive disorders.Purpose: to evaluate the refractive changes in children with ROP after transpupillary laser coagulation of the retina based by clinical experience.Materials and methods. We analyzed 5 clinical cases of children with ROP treated in Children's City Clinical Hospital No 1 during the period from 2013 to 2014. All patients underwent retinal transpupillary laser coagulation; its volume determined by the stage of ROP. Eye refraction data were noted at the age of 1 and 7 years. The quality of visual functions and the axial length of the eye were determined at the age of 7.Results. All patients had hyperopia of varying degrees at 1 years old. By the age of 7, one patient developed myopia, another one had emmetropia, while the rest of children had hyperopia of varying degrees. Regardless of the refractive error type, the axial length of the eye remained significantly below the age norm. The low quality of visual functions is due to the lack of full-time optical correction and irregular outpatient observation.Conclusions. Most often, hyperopia refraction in children with ROP is accompanied by a short axial length of the eye. Full-time optical correction should be prescribed, and spectacle wearing should be monitored by parents and ophthalmologists who observe the patients.
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