Tactical approaches to management of patients with macular pathology
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
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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