Authors
Bosov E.D., Bogdanova V.A., Saraeva S.N.
N.I. Pirogov National Medical Surgical Center, Moscow
Abstract
Rationale: Age-related macular degeneration in the modern world is one of the leading problems leading to blindness. It is a rapidly progressive disease characterized by damage to the central area of the retina.
Objective: The aim of the study was to evaluate the morphological and functional parameters of the retina after surgical treatment of submacular hemorrhages against the background of anti-vasoproliferative therapy in patients with a wet form of age-related macular degeneration.
Methods: The study was conducted on the basis of the Ophthalmology Center NMHC named by Pirogov (Moscow). It included 90 participants with an active form of age-related macular degeneration. The average age of the patients was 71.3 ± 8.5 years, including 50 women aged 61 to 82 years and 40 men aged 74 to 78 years. The rationale for the use of the “treat and extend” strategy in this work is the possibility of using fewer intravitreal injections compared to a fixed scheme that gives similar results of visual functions.
Conclusion: It can be concluded that the preservation of the vitreous body during minimally invasive vitreoretinal intervention allows you to adhere to the “treat and extend” mode without reducing the inter-injection interval.
Keywords: age-related macular degeneration, vitreoretinal surgery, submacular hemorrhage, retina, blindness, therapy.
References
1. Wong W.L., Su X., Li X., Cheung C.M., Klein R., Cheng C.Y., Wong T.Y. Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: a systematic review and meta-analysis. Lancet Glob Health. 2014;2(2):e106-e116. https://doi.org/10.1016/ S2214- 109X(13)70145-1.
2. Fajzrahmanov R.R., Shishkin M.M., Bosov E.D., Suhanova A.V., Mironov A.V. Patomorfologiya submakulyarnogo krovoizliyaniya (obzor) // Saratovskij nauchno-medicinskij zhurnal. 2021;17 (1): 28-32. (In Russ.)
3. Ovchinnikova A.D., Mironov A.V., Dulgieru T.O. Hirurgicheskoe lechenie massivnyh submakulyarnyh krovoizliyanij pri vlazhnoj forme vozrastnoj makulodistrofii s avtomatizirovannoj subretinal’noj in”ekciej. Oftal’mohirurgiya. 2020;4:43–49. (In Russ.) https://doi.org/10.25276/0235-4160-2020-4-43-49
4. Fajzrahmanov R.R., Bosov E.D., SHishkin M.M., Suhanova A.V. Izmenenie morfofunkcional’nyh pokazatelej setchatki pri hirurgii submakulyarnyh krovoizliyanij // Saratovskij nauchno-medicinskij zhurnal. 2021;17(2):388-392. (In Russ.) https://doi.org/10.21516/ 2072-0076-2023-16-3-87-93
5. Stanescu-Segall D., Balta F., Jackson T.L. Submacular hemorrhage in neovascular age-related macular degeneration: A synthesis of the literature. Surv Ophthalmol. 2016;61(1):18-32. https://doi.org/10.1016/j.survophthal.2015.04.004
6. Kim J.H., Kim C.G., Lee D.W. Intravitreal aflibercept for submacular hemorrhage secondary to neovascular age-related macular degeneration and polypoidal choroidal vasculopathy. Graefes Arch Clin Exp Ophthalmol. 2020;258(1): 107-116. https://doi.org/10.1007/s00417-019-04474-0
7. Okhotsimskaya T.D., Zaitseva O.V. Aflibercept for the therapy of retinal diseases. A review of clinical studies. Russian Ophthalmological Journal. 2017;10(2):103-111. (In Russ.) https://doi.org/10.21516/2072-0076-2017-10-2-103-111
8. Haritoglou C., Boneva S., Schultheiss M., Sebag J., Binder S. Vitreoretinale Chirurgie bei altersabhangiger Makuladegeneration. Die Ophthalmologie. 2023;120(10): 1004-1013. https://doi.org/10.1007/s00347-023-01933-2
9. Treumer F., Wienand S., Purtskhvanidze K., Roider J., Hillenkamp J. The role of pigment epithelial detachment in AMD with submacular hemorrhage treated with vitrectomy and subretinal co-application of rtPA and anti-VEGF. Graefes Arch Clin Exp Ophthalmol. 2017;255(6): 1115-1123. https://doi.org/10.1007/s00417-017-3620-2
10. Matsunaga D.R., Su D., Sioufi K., Obeid A., Wibbelsman T., Ho A.C., Regillo C.D. The Timing of Large Submacular Hemorrhage Secondary to Age-Related Macular Degeneration Relative to Anti-VEGF Therapy // Ophthalmol. Retina. 2021;5(4): 342-347. https://doi.org/10.1016/j.oret.2020.07.028
11. Okada M., Kandasamy R., Chong E.W., McGuiness M., Guymer R.H. The Treat-and-Extend Injection Regimen Versus Alternate Dosing Strategies in Age-related Macular Degeneration: A Systematic Review and Meta-analysis. Am. J. Ophthalmol. 2018;192: 184-197. https://doi.org/10.1016/j. ajo.2018.05.026
12. Edington M., Connolly J., Chong N.V. Pharmacokinetics of intravitreal anti-VEGF drugs in vitrectomized versus non-vitrectomized eyes. Expert Opin Drug Metab Toxicol. 2017:13(12): 1217-1224. https://doi.org/10.1080/ 17425255.2017.1404987
13. Fajzrahmanov R.R., Bosov E.D., Karpov G.O., Bogdanova V.A. Sposob maloinvazivnoj korrekcii submakulyarnyh krovoizliyanij // Patent No 2788357 C1 Rossijskaya Federaciya, MPK A61B 17/00, A61F 9/007. No 2022111518: zayavl. 27.04.2022: opubl. 17.01.2023 / zayavitel' Federal'noe gosudarstvennoe byudzhetnoe uchrezhdenie “Nacional'nyj mediko- hirurgicheskij Centr imeni N.I. Pirogova” Ministerstva zdravoohraneniya Rossijskoj Federacii.
14. Bosov E.D., Fajzrahmanov R.R., Karpov G.O., Kalinin M.E., Mironov A.V. Morfofunkcional’naya rezul’tativnost’ operativnogo lecheniya subretinal’nyh gemorragij. Sovremennye tekhnologii v oftal’mologii. 2022;1(41): 23-27. (In Russ.) https://doi.org/10.25276/2312-4911-2022-1-23-27
15. Fajzrahmanov R.R., Bosov E.D., Bogdanova V.A., Vaganova E.E., Sekhina O.L. Morfofunkcional’nye osobennosti pigmentnogo epiteliya setchatki v norme i pri vozrastnoj makulyarnoj degeneracii. Oftal’mohirurgiya. 2023;3:106-111. (In Russ.) https:// doi.org/10.25276/0235-4160-2023-3-106-111.