Підвищення клінічної ефективності хірургічного лікування регматогенного відшарування сітківки шляхом оцінювання імунологічних та анатомо-морфологічних показників: огляд літератури

Abstract

Introduction. Closed subtotal vitrectomy (CSV) is used to treat rhegmatogenous retinal detachment (RRD), but even with successful surgery performed at a relatively early stage, some patients still have low visual acuity and persistent color perception defects. Therefore, the combination of CVS with the internal limiting membrane (ILM) peeling in RRD can improve clinical outcomes in the postoperative period. The aim. To determine the role of ILM peeling and its influence on the functional and morphological state of the macula after RRD surgery in order to maximize the results of visual acuity after retinal detachment and clarify the indications for ILM removal in RRD. Materials and methods. Analysis of the literature shows that in many cases, despite the full ft of the detached retina, visual acuity is not restored in full. There are almost no data comparing the effect on visual acuity of ILM removal during vitrectomy in the remote period, hemodynamic disorders in the macular area according to optical coherence tomography (OCT) angiography in patients with RRD. Results. Despite the fact that ILM peeling in RRD significantly reduces the incidence of epiretinal fibrosis the anatomical and morphological changes of the retina after ILM peeling and their impact on postoperative clinical outcomes should be taken into account. The determination of blood biomarkers has the potential to better predict the risk of proliferative vitreoretinopathy (PVR) after surgery to inhibit the pathological reaction that causes the formation of fibrous films on the retina, which in turn significantly worsen the clinical outcomes in the postoperative period. Conclusions. Thus, a combination of appropriate surgical techniques and new diagnostic markers, both clinical and immunological, can help to improve the diagnosis and prognosis of RRD.