Saratov JOURNAL of Medical and Scientific Research

angiogenesis inhibitors

Tactical approaches to management of patients with macular pathology

Year: 2020, volume 16 Issue: №2 Pages: 683-687
Heading: Ophtalmology Article type: Original article
Authors: Chuprov A.D., Borshchuk E.L., Voronina A.E., Lositskiy А.О.
Organization: S. Fyodorov Eye Microsurgery Federal State Institution
Summary:

The purpose is to evaluate the effectiveness of tactical approaches to macular pathology treatment based on retrospective data analysis. Material and Methods. Between 2014 and 2019, 12007 courses of treatment of patients with macular pathology (1372 patients) were conducted at the S. Fyodorov Eye Microsurgery Federal State Institution, Orenburg branch. 69.5% of patients were diagnosed with "Macular and posterior pole degeneration" (H35.3), "Retinal angiomatosis" (H35.0) was diagnosed in 11.3%, cases with "Other specified retinal disorders" (H35.8) 9.4%. Results. Comparison of the best corrected visual acuity (BCVA) was made and 2 groups were distinguished: group 1 consisted of patients with negative dynamics, group 2 included patients with positive dynamics. Among all patients, the best values of BCVA were in patients diagnosed with "Other specified retinal disorders", while BCVA improved by 0.13 in most patients with this nosology, in case of macular edema (1.8% of the sample), an improvement in BCVA by 0.13 was also noted. Tactical approaches were analyzed in patients with the best BCVA values, and it was found that intravitreal injection of drugs (IVID) more often led to an increase or stabilization of BCVA in patients with various pathologies of the macular zone. In the sample the majority of patients with macular pathology were diagnosed with "Macular and posterior pole degeneration", 65.35% of patients in this nosological group had positive dynamics in BCVA in the course of 3 years. Conclusion. The most effective method of treating patients with the diagnosis "Macular and posterior pole degeneration" was intravitreal injection of angiogenesis inhibitors (Aflibercept and Ranibizumab) according to the regimen described in the instructions for these drugs.

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Pedicled retinal pigment epithelium — choroid graft autotranslocation in scarred age-related macular degeneration

Summary:

The purpose of the study is to analyse the effectiveness of pedicled RPE (retinal pigment epithelium) — choroid graft autotranslocation in scarred neovascular age-related macular degeneration (AMD) treatment. Material and Methods. Pedicled RPE — choroid graft autotranslocation was performed on 8 patients with scarred wet AMD. Follow-up was from 6 to 30 months. Visual acuity, ophthalmoscopy, optical coherent tomography and indocian-green angiography were analysed. Results. The average visual acuity increased from 0.009±0.006 to 0.018±0.022 (p=0.15). Visual acuity increased in 50% of the patients. In 50% of patients visual acuity decreased, which was associated with proliferative vitreoretinopathy in post-op period with retinal detachment formation. No cases of choroidal neovascularization recurrence were detected. According to angiography data normal choroidal perfusion in the rotated RPE — choroid patch was revealed after 1 month during the follow-up examination. Conclusion. Pedicled RPE — choroid graft translocation can be successively performed in case of scarred neovascular age-related macular degeneration.

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Combined approach to the surgical treatment of patients with prolifera-tive stage of diabetic retinopathy

Year: 2017, volume 13 Issue: №2 Pages: 338-345
Heading: Ophtalmology Article type: Original article
Authors: Bikbov M.M., Fayzrakhmanov R.R., Kalanov M.R.
Organization: State Budgetary Institution "Ufa eye research institute of the Academy of Sciences of the Republic of Bashkortostan"
Summary:

Purpose: to evaluate the effectiveness of combined surgical treatment in patients with proliferative stage of diabetic retinopathy. Material and Methods. 52 patients with advanced stage of proliferative diabetic retinopathy who were divided into 2 groups were examined. Group 1 consisted of 30 patients with a preliminary intravitreal injection of ranibi-zumab, followed by vitrectomy In group 2, 22 patients underwent vitrectomy without anti-VEGF therapy. Visual acuity in the 1st group before treatment was 0.04±0.02, in the second 0.05±0.03. The thickness of the retina in the foveolar zone of the 1st group was 358±34 urn, in the second 378±44 urn. Height of the complex "PHM with fibro-glial proliferation — retina" 670±38 and 710±30, respectively. Results. The visual acuity after treatment increased 4.2 times (group 1), in comparison with the results of the second group by 2.5 times. In patients of the 1st group intraoperative hemor-rhagic manifestations were observed in 36.6% of cases, in the 2nd group in all patients. An increase in the height of the complex "PHM with fibro-glial proliferation — retina" was noted in 83.3% in patients of the 1st group one month after the injection. The height of the complex increased on average to 153±25 urn, which in 76.6% increased the traction effect on the retina. The neovascularization regression occurred 4-8 days after ranibizumab injection in group 1 patients. The retinal thickness of the central zone 10 months after vitrectomy decreased to 220±10 urn in the 1st group and to 273±14 urn in the 2nd group, respectively. Conclusion. The use of inhibitors of angiogenesis, in particular ranibizumab, as a preoperative preparation of patients with proliferative stage of diabetic retinopathy reduces the risk of intra- and postoperative hemorrhagic complications, which facilitates the implementation of vitrectomy, avoids additional vitreo-retinal interventions, in connection with which a positive functional result remains.

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