In Russia, doctors saved the eyesight of a child with a rare course of a serious disease

Specialists of the Ophthalmology Department of the Russian Children's Clinical Hospital (RDKB) The Russian Ministry of Health conducted a successful multi—stage treatment for a child with an extremely rare course of severe disease - late reactivation of retinopathy of prematurity. The doctors managed to stabilize the pathological process and preserve the patient's eyesight. This was reported to Izvestia by the press service of the medical institution on April 18.

The boy from Moscow was born on the 32nd week of pregnancy. According to the RDCB, prematurity is a key factor in the development of retinopathy in children, since the retina of the eye does not have time to fully cover with blood vessels by the time of premature birth. In infancy, the child received treatment for retinopathy of prematurity — vascular endothelial growth factor inhibitor (VEGF). The drug blocks the excessive production of growth factor, which causes abnormal vascular growth in response to a lack of oxygen in the immature retina. The use of this technique made it possible to stop the pathological process in a child for 10 years.

At the age of 11, the boy began to complain of blurred vision. The ophthalmologist detected retinal detachment in the patient and referred him for hospitalization at the Russian Children's Clinical Hospital. According to Sergey Lesovoy, head of the ophthalmology department of this medical institution, as a result, a diagnosis was made of "late reactivation of retinopathy of prematurity" caused by the preservation of areas that had not sprouted blood vessels after initial treatment.

"It is precisely these areas that can begin to secrete growth factor again, provoking abnormal vascular development even years later. This is an extremely rare phenomenon, cases in children over the age of five or seven are rare in world practice and have practically not been studied," he said.

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The doctors decided to apply a tactic similar to the treatment of the active phase of retinopathy of premature newborns, adapting it to the patient's condition. In the left eye, where retinal detachment had already developed, the treatment was carried out in two stages. At the first stage, a SAFR inhibitor was introduced to suppress the activated pathological growth of blood vessels, and at the second stage, a complex vitreoretinal surgical procedure was performed and the altered vitreous and scar tissue were removed from the surface of the retina.

"The microinvasive operation was performed through punctures with a diameter of about half a millimeter. We dissected and removed multiple scar tissue in the vitreous body, which caused retinal detachment, which allowed it to partially straighten out already during surgery. Laser coagulation was also performed to prevent the recurrence of detachment," explained ophthalmologist Yulia Kuznetsova.

On the right eye, where there was no detachment, but avascular zones were present, laser coagulation of the retina was also performed — it was necessary to prevent further pathological vascular growth and disease progression.

Specialists managed to save the boy's eyesight and stop the dangerous pathological process. In the left eye, where retinal detachment had already occurred, visual function recovered from 2 to 30% of normal values. Visual acuity in the right eye also improved to 80% of normal. Now, with the help of eyeglass correction, the child will be able to see normally.

Earlier, on March 27, ophthalmologist, microsurgeon at SM Clinic, Candidate of Medical Sciences Svetlana Mirgorodskaya told Izvestia that retinal detachment is a dangerous pathology. It occurs due to ruptures or vitreoretinal proliferation, which can develop against the background of diabetic retinopathy, as well as infectious lesions — bacterial or viral. A problem can be suspected by symptoms such as flashes of light, lightning in the field of vision, or the appearance of floating dark spots.