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Qualitative expert assessment of the condition of a patient's ocular fundus in severe and advanced stages of proliferative diabetic retinopathy

Year: 2024, volume 20 Issue: №1 Pages: 13-17
Heading: Ophthalmology Article type: Original article
Authors: Teshev A.F., Malyshev A.V.
Organization: Research Institute — Regional Clinical Hospital No. 1 n. a. Professors. V. Ochapovsky, Adygea Republican Clinical Hospital, Maikop, Russia
Summary:

Objective: comparative qualitative expert assessment of the condition of the patient's fundus in severe and advanced stages of proliferative diabetic retinopathy (PDR). Material and methods. An assessment was made of the developed qualitative criteria for the condition of the fundus in patients with the following stages of PDR: severe-high risk 1 (SHRPDR-1, 32 eyes), severe-high risk 2 (SHRPDR-2, 32 eyes) and advanced (APDR, 34 eyes). The developed criteria (preretinal hemorrhage, fibrosis of the posterior hyaloid membrane, vitreous hemorrhage, etc.) were assessed by one ophthalmic surgeon on a point scale: 1 point — initial changes; 2 — weak, but more pronounced (compared to 1 point) changes; 3 — severity of moderate changes; 4 — pronounced changes. Results. The greatest increase in the average score in the group of patients with APDR (compared with SHRPDR-1 and SHRPDR-2) was established according to the following criteria: fibrovascular tissue in the area of the optic nerve head and along the vascular arcades (2 times), fibrosis of the posterior hyaloid membrane (1.5 times), vitreous hemorrhage (1.4 times); for other criteria, the increase in average score varies from 28 to 93%. At the same time, there is only a tendency for the criteria to worsen between SHRPDR-1 and SHRPDR-2 (p>0.05). Conclusion. A significant deterioration of all criteria was established in patients with APDR compared with SHRPDR-1 and SHRPDR-2.

Keywords: vitrectomy, fundus, diabetes mellitus

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