First Author: R.Fayzrakhmanov RUSSIA
Co Author(s): M. Bikbov
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To study the dynamics of morphological and functional parameters of the central retina in patients with fibrovascular membrane in macular degeneration on the background of the use of angiogenesis blockers.
Ufa Eye Research Institute, Ufa, Russia
76 patients (76 eyes) with active fibrovascular membrane in AMD were examined. The average age of the patients was 68 ± 6,5, visual acuity - 0.1 ± 0.16. All patients received intravitreal ranibizumab dose of 0.05 ml (0.5 mg). Groups under research: Group 1 - 33 patients (33 eyes) - triple intravitreal injection with an interval of 1 month. Group 2 - 43 patients (43 eyes) - single intravitreal ranibizumab injection. All patients underwent a complete ophthalmological examination, including visometry, perimetry, ophthalmoscopy. Additional examinations were: Optical coherence tomography (OCT) using RetinaScan device - 3000 (NIDEK), microperimetry, which is performed with MR-1 (Nidek technologies) device and the program «Maculopathy». Postoperative follow-up was 3 months.
Increase in light sensitivity of the central retina from 1.22 ± 0.95 dB up to 3.97 ± 1.21 dB (p <0.05), visual acuity - from 0,08 ± 0,06 to 0,11 ± 0,05 with triple use of angiogenesis blockers were observed in the 1st group. After the first injection the indicators of fixation test changed on average from of ± 12.11o 4.62o to 6.24o ± 3.66o, in subsequent injections position of the fixation point remained practically unchanged and remained at this level. The height of the membrane decreased to 113.03 ± 42.17 µm, compared with the data prior to the therapy (141.76 ± 42.91 µm). Reduction of the membrane (p <0.05) was observed in some parts of the retina. The height of the photoreceptor layer was 63.44 ± 23.85 µm, statistically significant (p <0.05) different from the parameters before treatment (125.46 ± 36.11 µm). The thickness of the retina decreased to 228.84 ± 94.48 µm (before treatment - 443.24 ± 132.91 µm, p <0.05). Maximal effect of antivazoproliferativnoy therapy was observed after a single injection of anti-VEGF drugs. In the 2nd group stabilization of morphological and functional parameters of the central retina was noted after a single injection of the drug.
Changes of morphological and functional parameters are registered during the entire treatment, which show the efficacy of antivasoproliferative therapy. The most significant change in the functional parameters of the macular zone occurs after the first course of therapy. On this basis, antivasoproliferative therapy is effective only in the case of a single intravitreal injection for active fibrovascular membrane.