Alexander A Shpak1, Dmitry O Shkvorchenko2, Eugenia A Krupina2. 1. The S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russian Federation. a_shpak@inbox.ru. 2. The S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russian Federation.
Abstract
PURPOSE: To compare the results of treatment of idiopathic full-thickness macular holes (MHs) with and without the use of autologous platelet-rich plasma (APRP). METHODS: This partially retrospective study included 152 patients (152 eyes) with MHs operated in the years 2010-2014 using conventional technology with internal limiting membrane peeling (control group) and 62 patients (62 eyes), operated by the same surgeons in 2015-2017 with additional application of APRP on MH (platelet group). Pre and postoperative best-corrected visual acuities (BCVA) were recorded, and retinal microstructure was studied using optical coherence tomography. Thirty-seven patients in the platelet group and 80 controls were followed for at least 12 months (for visual outcomes 15 controls were followed for 15-24 months). The data of 72 controls (72 eyes) were analyzed retrospectively. RESULTS: The minimum diameter of the MH in the platelet group was larger than in controls: 454 ± 186 vsersus 381 ± 148 μm (P = 0.003). Despite this, all MHs in the platelet group were closed, while in the control group 11 holes (7.2%) remained open (P = 0.036). The final mean BCVA, standardized by the minimum diameter of the macular hole, was higher in the platelet group by 3.9 ETDRS letters (P = 0.012). After surgery with APRP, foveal hyperreflective lesion (presumably glial proliferation) was found, which persisted in most large MHs, but gradually disappeared in small and most medium MHs. CONCLUSION: The use of APRP significantly improves the anatomical and functional results of treatment of idiopathic MHs. In very large MHs, APRP presumably enhances glial proliferation, which ensures their closure.
PURPOSE: To compare the results of treatment of idiopathic full-thickness macular holes (MHs) with and without the use of autologous platelet-rich plasma (APRP). METHODS: This partially retrospective study included 152 patients (152 eyes) with MHs operated in the years 2010-2014 using conventional technology with internal limiting membrane peeling (control group) and 62 patients (62 eyes), operated by the same surgeons in 2015-2017 with additional application of APRP on MH (platelet group). Pre and postoperative best-corrected visual acuities (BCVA) were recorded, and retinal microstructure was studied using optical coherence tomography. Thirty-seven patients in the platelet group and 80 controls were followed for at least 12 months (for visual outcomes 15 controls were followed for 15-24 months). The data of 72 controls (72 eyes) were analyzed retrospectively. RESULTS: The minimum diameter of the MH in the platelet group was larger than in controls: 454 ± 186 vsersus 381 ± 148 μm (P = 0.003). Despite this, all MHs in the platelet group were closed, while in the control group 11 holes (7.2%) remained open (P = 0.036). The final mean BCVA, standardized by the minimum diameter of the macular hole, was higher in the platelet group by 3.9 ETDRS letters (P = 0.012). After surgery with APRP, foveal hyperreflective lesion (presumably glial proliferation) was found, which persisted in most large MHs, but gradually disappeared in small and most medium MHs. CONCLUSION: The use of APRP significantly improves the anatomical and functional results of treatment of idiopathic MHs. In very large MHs, APRP presumably enhances glial proliferation, which ensures their closure.
Authors: Jay S Duker; Peter K Kaiser; Susanne Binder; Marc D de Smet; Alain Gaudric; Elias Reichel; SriniVas R Sadda; Jerry Sebag; Richard F Spaide; Peter Stalmans Journal: Ophthalmology Date: 2013-09-17 Impact factor: 12.079
Authors: M Paques; C Chastang; A Mathis; J Sahel; P Massin; C Dosquet; J F Korobelnik; J F Le Gargasson; A Gaudric Journal: Ophthalmology Date: 1999-05 Impact factor: 12.079
Authors: A Gaudric; P Massin; M Paques; P Y Santiago; J E Guez; J F Le Gargasson; O Mundler; L Drouet Journal: Graefes Arch Clin Exp Ophthalmol Date: 1995-09 Impact factor: 3.117