Pattern‐stimulation in the complex management of patients with operated retinal detachment

Abstract

AbstractIntroductionThe problem of increasing visual function after surgical treatment of retinal detachment retains its relevance. Existing methods do not take into account the possibilities of the retinal‐cortex system stimulation.ObjectiveEvaluation of the functional effect of pattern‐stimulation in the complex management of retinal detachment operated patients.Patients and methodsForty patients with an extrascleral retinal procedure. The median of age is 53.6 [23; 75] years. Patients in group 1a (10 eyes with macula‐on before surgery) and 1b group (with macula‐off before surgery) underwent a course of drug therapy (peptides, meldonium, antioxidants), patients of group 2a (10 eyes macula‐on before surgery) and 2b Groups (macula‐off before surgery) – a similar course of drug treatment combined with a pattern‐stimulation course. All groups are comparable in age, sex, visual acuity, data of electrophysiological studies – macular electroretinogram (ERG), visual evoked cortical potentials (VECP). According to the results of optical coherent tomography carried out before the start of treatment, there were no gross organic changes in the area of the macula in patients. Starting treatment 6 months after surgery. Evaluation of the treatment effectiveness after 3 months after its completion.ResultsIncreased visual acuity after treatment in group Ia occurred at 0.05, in group Ib by 0.03, in group IIa by 0.17, in group IIb by 0.21. The amplitude of wave‐a of macular ERG increased by 4.07 mV in group Ia, by 5.4 mV in group Ib, by 2.9 mV in group IIa, by 8.17 mV in group IIb; changes in wave amplitude‐in different directions: in group Ia, an increase of 3.5 mV, in group Ib a decrease of 0.4 mV, in group IIa and IIb an increase of 5.19 mV and 10.86 mV, respectively. VECP N 75 latency decreased by group Ia by 1.46 ms, by group 19.2 ms by group IIa, by 14.94 ms by group IIb, and increased by 1.1 ms by group Ib; P100 decrease in groups: Ia by 0.93 ms, IIa by 14.39 ms, IIb by 14.94 ms, increase in group Ib by 1.2 ms; the amplitude of the N75‐P100 VECP wave increased in all groups: Ia by 1.3 mV, Ib by 1.55 mV, IIa by 3.48 mV, IIb by 10.58 mV. An increase in visual acuity on the background of drug treatment correlated with an improvement in the amplitude characteristics of the local ERG (r = 0.47), using pattern stimulation with an increase in the amplitude characteristics of the VECP (r = 0.46).ConclusionUsing the stimulation pattern in complex management of the retinal detachment operated patients helps to improve the amplitude indices of local ERG and VECP by more than three times, reducing VECP latency values, increasing visual acuity 4 times in comparison with the routine drug therapy results in patients 1a and 1b groups. The results obtained indicate the feasibility of using the method of pattern‐stimulation in patients with operated retinal detachment to enhance the functional effect of surgical treatment.