The Evolution of Ophthalmological Healthcare System in Premature Children

Abstract

The purposeis to analyze the stages of ophthalmological healthcare system’s evolution in premature children on the basis of Kaluga branch of FGAU «MNTK “Eye Microsurgery” named after acad. S.N. Fedorov».Methods. In 2003, on the basis of Kaluga branch of MNTK “Eye Microsurgery” the system of ophthalmological care for premature children had been created. The specialists of children’s ophthalmologic department of the branch had started regular field screening examinations of premature infants from risk group of ROP in neonatal care unit in 4 regions of the Central Federal district. In parallel, new diagnostic methods and technologies of laser and surgical treatment of active PH stages had been actively developed and introduced.Results. From 2003 to 2018 approaches for detection, diagnostics and treatment of ROP had been evolved substantially. At the initial stage, there were no uniform data about the optimal timing for early detection of active stages ROP, and quantitative markers of ROP progression were not determined. The effective management and treatment algorithms for the patients with active ROP had not been implemented yet. To the date vast experience had accumulated: more than 15 thousand infants with ROP risk had been screened, more than 750 on-site examinations in the neonatal care units and perinatal centers had been performed. High-tech methods of diagnostics, laser and surgical treatment of ROP had been developed and are actively used now. Multicenter clinical studies evaluating the possibilities of anti-VEGF therapy for active ROP have being performed. Over 3000 laser and more than 1.300 surgical operations for different stages of ROP had been performed.Conclusion. Many-years experience of ophthalmological healthcare system in premature children functioning have demonstrated its consistency and effectiveness. The system includes interrelated stages, providing continuity between the perinatal centers and specialized ophthalmic institution, with complying the common approaches to early screening and diagnostic monitoring, including through telemedicine, as well as technologies of laser and surgical treatment of ROP.

Features of the Anterior Segment of the Eyeball in Children with 5 Cicatricial Retinopathy of Prematurity According to Ultrasound Biomicroscopy and Optical Coherent Tomography

“…При этом стандартные методы исследования зачастую не позволяют в полной мере оценить характер и степень патологических изменений структур переднего сегмента глаза. В настоящее время серьезно расширился спектр диагностических методик исследования за счет таких высокоинформативных, как ультразвуковая биомикроскопия (УБМ) и оптическая когерентная томография (ОКТ) переднего отрезка глаза, позволяющих качественно оценить взаимоотношения структур переднего отрезка у взрослого человека при патологии роговицы, глаукоме, травме глаза [7][8][9].…”