Abstract
Background. The purpose was to study the effectiveness of diabetic retinopathy (DR) treatment with different methods and to establish prognostic indicators of its failure. Materials and methods. A total of 358 patients (358 eyes) with type 2 diabetes were examined and divided into groups: 1 — with non-proliferative DR (NPDR; 189 eyes), 2 — with preproliferative DR (PPDR; 96 eyes) and 3 — with proliferative DR (PDR; 73 eyes). The central retinal thickness and central retinal volume were determined by optical coherence tomography; serum fasting glucose, glycated hemoglobin, cholesterol, high-, low- and very-low-density lipoproteins, triglycerides, fibrinogen — by colorimetric method; coagulation hemostasis parameters were evaluated as well. Patients were followed for 2 years with conservative, laser, surgical treatment and anti-VEGF therapy. The study results were analyzed using the EZR v. 1.54 package (Austria). Results. Conservative treatment was effective in 54.5 % of patients with NPDR. In PPDR and PDR, 98.8 % of patients showed slow or rapid progression of retinopathy after treatment. The independent factors that determined the failure of treatment for NPDR were the patient’s age, diabetes duration, blood cholesterol and glycated hemoglobin levels, as well as activated plasma recalcification time and thrombin time. The independent factors that determined the ineffectiveness of treatment for PPDR and PDR were blood triglycerides, prothrombin time and activated partial thromboplastin time. Conclusions. Lipid metabolism disorders and coagulation homeostasis were powerful factors in the progression of DR and treatment failure. The ineffectiveness of NPDR treatment increased with age and duration of diabetes.
Published Version
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