Search

Purpose. Evaluation of structural changes in the macular area after surgical treatment of idiopathic macular holes (MH) with the use of autologous platelet-rich plasma (PRP) in terms up to 12 months. Material and methods. We examined 41 persons (45 eyes) with idiopathic MH; patients were under observation at least 12 (up to 24) months after surgery with application of PRP to MH region. Twelve eyes with a minimum diameter of MH of at least 440 µm were allocated to the subgroup «≥440 µm». For it the control group was formed of 19 patients (19 eyes) with MH of similar sizes, successfully operated earlier by standard technology. Optical coherence tomography (OCT) and other examinations were performed at 1, 3, 6 and 12 months after operation. Results. One month after the operation with the use of a PRP, OCT demonstrated in the region of the MH an area of increased optical density and a defect of the ellipsoid zone of photoreceptors. In the eyes with a minimum diameter of MH 440 µm or more, these changes by 12 months were mostly preserved, although the defect of the ellipsoid zone was significantly reduced. In the eyes with MH less than 360µm the normal structure of the retina was restored up to 3-12 months. In the eyes with MH of 360-439 µm both variants of changes were observed. In the subgroup «≥440 µm», despite a significantly larger size of the MH, the visual functions at the end of the observation period did not differ much from the control group. Conclusion. One month after surgical treatment of MH with the use of PRP, OCT demonstrated in the region of hole the area of increased optical density and the defect of the ellipsoid zone of photoreceptors, which by 12 months decreased in size, and at MH with a minimum diameter less than 360 µm were not determined. In comparison with the standard surgical technology, the use of PRP did not have a negative impact on the functional outcome of the operation.

Purpose. Evaluation of the results of treatment of idiopathic macular holes (MH) with the use of autologous platelet-rich plasma (PRP) in comparison with standard technology in terms of up to 12 months.Material and methods. We examined 62 people (66 eyes) with MH, operated by two highly skilled surgeons, with application of PRP on the MH (the main group). The control group consisted of 165 patients (173 eyes) operated by the same surgeons in 2010-14 by standard technology.Results. The compared groups did not differ in age-sex characteristics, axial length of the eye, hole duration. Parameters of the MH and foveal region were significantly worse in the main group compared to the control group; in particular, the minimum diameter of the hole was 445±184 μm vs. 376±149 μm. Despite this, the anatomical and functional results of the treatment in the main group were significantly better than in the control group. In all patients of the main group, it was possible to achieve complete closure of the hole, while in the control group the hole was not blocked in 14 eyes (P=0.013). Measured 12 months after surgery, the median increase in visual acuity was almost 9 ETDRS letters greater in the main group (P=0.012).Conclusion. The use of PRP significantly improves the anatomical and functional results of treatment of idiopathic MH, including MH of large diameter and with an unfa vorable prognosis for standard surgery.

Purpose. Evaluation of the results of the use of Autologous Conditioned Plasma in Management refractory macular hole. Materials and methods. We examined рatient B., 56 years old, with a refractory macular hole (MH), which did not close after two operations. Earlier, the patient underwent cataract phacoemulsification with IOL implantation. Along with traditional methods of examination, optical coherence tomography was performed. Before the operation, Autologous Conditioned Рlasma (ACP) was prepared by centrifuging the patient's blood. After removing the silicone oil, the AСР was injected of the MH zone. The operation was completed with a gas-air tamponade. After the operation, recommended position was "face down" for a day. Results. In the early postoperative period, during biomicroscopy, MH was closure. 2 weeks after surgery, on optical coherence tomography (OCT) there MH was closure. Her best-corrected visual acuity (BCVA) the maximum corrected was 0.01 to 0.15. Patient said about the improvement in the quality of vision and a decrease in metamorphopsies. Conclusion. The use of AСР in the Management of refractory MH is an effective method with good anatomical and functional results. Keywords: refractory macular hole, Autologous Conditioned Plasma, optical coherence tomography, anatomical result.

To compare the changes of the macular morphological and functional parameters in the postoperative period in patients with silicone oil tamponade after successful surgery of the macula-on rhegmatogenous retinal detachment (RRD).The study included 20 eyes operated on for macula-on RRD, which made up the first group, and the control group (20 eyes) for comparison. All patients of the study group underwent vitrectomy using silicone oil tamponade. Standard ophthalmological examination was performed on the 3rd day (early postoperative period) and the 14th day (late postoperative period), including OCT and OCT-A that were used to assess morphological and functional changes.A significant decrease in visual acuity was seen on the 3rd day after surgery involving the use of silicone oil tamponade, in comparison with the 14th day (Сравнить изменение морфофункциональных показателей макулярной зоны в послеоперационном периоде у пациентов с силиконовой тампонадой (СТ) после успешного хирургического лечения macula-on регматогенной отслойки сетчатки (РОС).В исследование включено 20 пациентов (20 глаз), прооперированных по поводу macula-on РОС. Прооперированные глаза составили 1-ю группу, которая сравнивалась с группой контроля (2-я группа; 20 парных глаз без офтальмопатологии). На всех глазах 1-й группы выполнена витрэктомия с использованием СТ. Стандартное офтальмологическое обследование выполнялось на 3-и (ранний послеоперационный период) и 14-е сутки (поздний послеоперационный период); кроме того, для оценки морфофункциональных изменений использовали оптическую когерентную томографию, в том числе в режиме ангиографии.На 3-и сутки после операции с использованием СТ выявлено достоверное снижение остроты зрения в сравнении с показателем на 14-е сутки (