METHOD FOR DETERMINATION OF INDICATIONS TO PRIMARY VITREORETINAL SURGERY AT POSTERIOR AGGRESSIVE RETINOPATHY OF PREMATURE NEWBORNS Russian patent published in 2017 - IPC A61B3/12 A61B8/10 

FIELD: medicine.

SUBSTANCE: digital retinoscopy is performed and fundus clinical picture is evaluated. Digital morphometry is performed with measurement of the diameter of the main arteries and veins, as well as arteries and veins in close proximity to the proliferation shaft (peripheral). The coefficient of artery tortuosity (TC) is calculated. Fundus fluorescent angiography is performed. Spectral OCT is carried out with measurement of retinal thickness in the macular area and in the projection of the proliferation shaft. The state of the vitreomacular interface is evaluated. Ultrasound B-scanning is performed to determine the state of the vitreous body, presence of synechias, membranes fixed to the retina, retinal detachment zones, to measure its height and area. In the presence of the following clinical picture: vascularization in the 1st and rear 2nd fundus areas, sharp expansion and tortuosity of retinal vessels, foci of extraretinal proliferation in the vascularized retina, wide proliferation shaft in the form of an open ring with a length of more than 8 hour meridians, exudative detachment under the proliferation shaft in 2 or more fundus quadrants, numerous vitreoretinal tracts above the shaft, not reaching the vitreous body basis; digital morphometry data: central arteries diameter - 95.084.27 mcm, peripheral arteries diameter - 78.296.98 mcm, central veins diameter - 157.686.22 mcm, peripheral veins diameter - 78.394.66 mcm, TC - 1.2030.066; ultrasonic B-scan data: areas of uneven retinal thickening in the posterior pole of the eye spreading to the middle periphery, prominence height up to 4 mm, vitreous opacification in the form of a hypoechoic suspension of varying intensity, preretinal membranes of low and moderate acoustic density with fixation to the proliferation shaft apex and presence of retinal detachment areas with height of up to 1.5 mm and length of more than 2 quadrants; spectral OCT data: compaction sites of the internal border membrane and single epiretinal proliferation zones within the macular region, diffuse retinal edema up to 310 mcm, "sawtooth" contour of the vitreoretinal interface in the macular area due tovasodilation and expressed retinal vessels tortuosity, numerous areas of epitelial proliferation in all segments on the border between vascularized and avascular areas of the retina in the form of hyper-reflective "mushroom" conglomerates, "ridge" extraretinal proliferation shaft in all segments with retinovitreal neovascularization, both in the projection of the proliferation shaft, and before it within the vascularized retina, the growth of neovascular complexes in the form of "brushes" along the posterior hyaloid membrane into the vitreous cavity with the formation of multiple highly reflexive conglomerates on its surface; FAG data: the extreme degree of retinal vascular system disorganization with the loss of the retinal capillary bed in its vascularized part, the presence of ischemia areas up to 5 diameters of the optic nerve disk, the presence of a proliferation shaft in the form of a hyperfluorescent "ridge" consisting of a multilayered "brush" retinovitreal neovascularization with a massive extravasal yield of fluorescein, primary vitreoretinal surgery in the posterior aggressive retinopathy is considered prescribed with no preliminary transpupillus LKS.

EFFECT: invention provides determination of clear indications for primary vitreoretinal surgery for posterior aggressive RN, which are based on the characteristic of the fundus clinical picture according to digital retinoscopy in conjunction with objective morphometric vascular parameters and FAG, spectral OCT and ultrasound B-scan data, providing objectification of the received data, allows to correctly select patients for primary vitreoretinal surgery, promotes rapid disease transition to the inactive stage and leads to the achievement of a satisfactory anatomical result postoperatively.

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