Комбинированное лечение тяжелых форм диабетической ретинопатии

Abstract

Purpose. To evaluate the efficacy and safety of combined treatment of proliferative diabetic retinopathy (PDR), including primary vitrectomy and delayed single-stage patterned panretinal retinal laser coagulation (PLC). Material and methods. The study included 28 patients (28 eyes) with newly diagnosed PDD complicated by hemophthalmos and / or local traction retinal detachment with or without 1-2 stage gliosis, against the background of sub- or decompensation of the course of diabetes mellitus (DM). At the initial examination, a standard ophthalmological examination was performed, as well as fundus photography (Visucam 500, Carl Zeiss, Germany), optical coherence tomography (OCT) (STRATUS OCT Carl Zeiss, Germany). The best corrected visual acuity (BCVA) at admission ranged from light projection to 0.4. All patients were undergone combined treatment. Results. 1-1.5 months after pattern PLC, patients showed regression of neovascularization, ischemic zones were completely blocked, in cases of iris neovascularization, its regression was noted. According to OCT data, the height of edema in the macular zone did not increase. In all cases, the removal of silicone oil was completed within 1-2 months. The indices of BCVA increased and varied from 0.1 to 0.7 after the removal of the silicone oil. According to OCT data, 17 patients showed a decrease in the height of retinal edema in the macular zone from 73 to 150 µm. Conclusion. In the postoperative period after vitreoretinated surgery in patients with PDR, one-stage patterned PLC allows to stabilize the course of the disease in a shorter time and shorten the time of silicone tamponade of the vitreous cavity. Key words: proliferative diabetic retinopathy, vitrectomy, silicone tamponade of the vitreous cavity, patterned panretinal laser coagulation of the retina.