Abstract
Background. A common cause of visual impairment in patients with non-infectious uveitis is macular edema, developing in 38–84 % of cases. Plasma enriched with platelets is widely used in various branches of medicine, the effectiveness of its use in the treatment of non-infectious uveitis, accompanied by macular edema, has not been sufficiently investigated. Aim: To evaluate the effectiveness of autologous platelet-rich plasma in the complex treatment of non-infectious uveitis accompanied by macular edema.Material and methods. The study was conducted on the basis of the academician S.N. Fyodorov Eye Microsurgery Federal State Institution in the period from 2016 to 2018, which included 123 people (176 eyes) from 18 to 50 years with non-infectious uveitis, accompanied by macular edema: 46 men, 77 women. Patients were divided into 2 groups. The main group consisted of patients receiving autologous platelet-rich plasma and anti-inflammatory treatment; the comparison group consisted of patients receiving anti-inflammatory treatment. The results of visual acuity, intraocular pressure, biomicroophthalmoscopy, optical coherence tomography of the macular zone, microperimetry, ultrasound examination on the side of the affected eye were evaluated. Statistical processing of the data was carried out in the program Statistica 10.Results. Maintenance of autologous platelet-rich plasma contributes to a statistically significant improvement in visual acuity on the 10th day of treatment by 64.2 %, a decrease in the thickness of the retina in fovea by 36.3 % and an increase in retinal photosensitivity by 34.6 % compared to the group of patients receiving only anti-inflammatory treatment. Conclusions. The use of autologous platelet-rich plasma in the complex treatment of non-infectious uveitis allows to accelerate the natural mechanisms of tissue regeneration, contributing to the reduction of macular edema, and improve visual performance.
Highlights
A common cause of visual impairment in patients with non-infectious uveitis is macular edema, developing in 38–84 % of cases
Maintenance of autologous platelet-rich plasma contributes to a statistically significant improvement in visual acuity on the 10th day of treatment by 64.2 %, a decrease in the thickness of the retina in fovea by 36.3 % and an increase in retinal photosensitivity by 34.6 % compared to the group of patients receiving only anti-inflammatory treatment
The use of autologous platelet-rich plasma in the complex treatment of non-infectious uveitis allows to accelerate the natural mechanisms of tissue regeneration, contributing to the reduction of macular edema, and improve visual performance
Summary
Maintenance of autologous platelet-rich plasma contributes to a statistically significant improvement in visual acuity on the 10th day of treatment by 64.2 %, a decrease in the thickness of the retina in fovea by 36.3 % and an increase in retinal photosensitivity by 34.6 % compared to the group of patients receiving only anti-inflammatory treatment. В США ежегодно регистрируются до 30 000 новых случаев слепоты вследствие увеитов [3]. Инвалидность вследствие увеитов зарегистрирована в среднем у 30 % пациентов, достигая 50–60 % при тяжёлых системных заболеваниях [4]. Наиболее распространённой причиной нарушения зрения у пациентов с неинфекционным увеитом является макулярный отёк, который развивается при любой локализации воспалительного процесса [5, 6, 7]. Макулярный отёк при воспалительных заболеваниях глаза имеет склонность к рецидивированию и часто ассоциируется с системными заболеваниями [8]. В случае тяжёлого течения увеита макулярный отёк возникает в 38–84 % случаев [9]. Частота выявления более высокого уровня поражения макулы с использованием ОКТ достигает 25 %, а у пациентов с длительно существующим хроническим неинфекционным увеитом макулярный отёк встречается в 47 % случаев [11]. В последние годы в различных отраслях медицины активно изучается использование аутологичной плазмы, обогащённой тромбоцитами, для активации репаративных процессов, обусловленной воздействием большого количества биологически активных веществ, выделяемых альфа-гранулами активированных тромбоцитов [14]
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