Структурные изменения макулярной области после хирургического лечения макулярных разрывов с применением богатой тромбоцитами плазмы крови

[摘要] 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.

[学科分类] 眼科学

[关键词] idiopathic macular hole;platelet-rich plasma;optical coherence tomography;visual acuity;central retinal sensitivity.;идиопатический макулярный разрыв;богатая тромбоцитами плазма;оптическая когерентная томография;острота зрения;центральная светочувствительность.