Анализ эффективности прецизионной эндолазеркоагуляции сетчатки у пациентов с пролиферативной диабетической ретинопатией с использованием интраоперационной флуоресцеиновой ангиографии

Abstract

Purpose. To analyze the efficacy of the initial precision retinal endolaser coagulation during subtotal vitrectomy in patients with proliferative diabetic retinopathy (PDR) complicated by intraocular hemorrhage, using intraoperative fluorescein angiography (FAG). Material and methods. The study included 55 patients (61 eyes). All patients were divided into 2 groups: in the group I (24 patients, 29 eyes) endo-laser coagulation of the retina was performed based on intraoperative fluorescein angiography results; patients of the group II (31 patients, 32 eyes) endo-laser coagulation of the retina was performed without angiography data. Results. According to the FAG, carried out after 3 months, areas of hyper-fluorescence in peripheral parts of the retina outside the area of retinal photocoagulation were revealed in the groups I and II (in 4 eyes (20%) and 12 eyes (60%), respectively) as well as macular edema (1 eye (5%) and in 6 eyes (30%), respectively). The computer perimetry detected an absolute scotoma in the laser coagulation area in 28 cases (45.9%), outside the laser coagulation sites – in 30 cases (49.2%), outside and inside the laser coagulation zone – in 1 case (1.6%), and tubular vision – in 2 cases (3.3%). Conclusion. The intraoperative FAG application allowed to perform the endo-laser coagulation of the retina under a dosed control. This technique allows to optimize and reduce the number of coagulates and thus to avoid complications associated with laser treatment, to avoid the damage of intact retina and to preserve the peripheral vision.