SCREENING STUDIES OF RETINOPATHY OF PREMATURITY AND ITS PROSPECTS FOR OPHTHALMOLOGY

Abstract

Our studies established that the maturation of biochemical autoregulation of retinal vessels began from the 30th week of postconceptual age [7]. The causes of delayed maturation of vascular autoregulation have been identified. In the majority of children (70–80%), adaptation to new living conditions was successful, but in every 3–4th child, failure of autoregulation of retinal vessels was detected and ROP developed. We noted that the maturation of vascular autoregulation is delayed not only by gestational age, but also by concomitant diseases. These include severe forms of respiratory distress syndrome, anemia, neonatal sepsis, thrombocytopenia, multiple blood transfusions, apnea, and intraventricular hemorrhages. Inappropriate vasospasm. The lower the degree of maturity of the child, the more often retinal arteriospasm is detected. In those born at 25–27 weeks, arteriospasm was detected in 82% of cases, at 28–29 weeks – in 67%, at 30–32 weeks – in 54% of cases. For the development of ROP, it is not so much vasospasm that is important as its degree, i.e. the degree of obstruction of blood flow caused by vasospasm. We assessed hemodynamics in the anterior cerebral artery and in the ophthalmic artery using the resistance index. An index of cerebral and ocular vascular resistance of 0.8 or higher is threatening for the development of ROP in a child. The resistance index, a routine method for studying the vessels of the brain and eye, makes it possible to monitor the degree of vasospasm even when it is impossible to perform ophthalmoscopy (opacity of the optical media, secclusion of the pupil, etc.). It is enough to study the cerebral vascular resistance index to determine the threat of development.