Analysis of the relationship between coagulogram deviations and development of recurrent full-thickness macular holes after surgical treatment with autologous platelet-rich plasma
- Authors: Gusakov M.V.1,2, Kochergin S.A.1,2, Ovsyanko A.A.1,2
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Affiliations:
- Moscow City Ophthalmological Center, S.P. Botkin Hospital
- Department of Ophthalmology, Russian Medical Academy of Continuous Professional Education
- Issue: Vol 14, No 2 (2025): Сова-2025. Материалы XIX Международной научно-практической конференции молодых ученых-медиков СОВА-2025
- Pages: 39-40
- Section: СОВА
- URL: https://new.vestnik-surgery.com/index.php/2415-7805/article/view/10783
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Abstract
Surgical treatment of full-thickness macular holes (FTMHs) with the application of autologous platelet-rich plasma on the neuroepithelial defect site is associated with the restoration of the anatomical profile of the macular region and the improvement of visual acuity. However, there are instances of incomplete closure and the recurrence of FTMHs following this type of vitrectomy. To date, there is no definitive consensus on the reasons for the lack of positive outcomes after surgical treatment. This study evaluates the impact of coagulation system deviations as a potential factor influencing the outcomes of surgical treatment for FTMHs using autologous platelet-rich plasma.Based on the results of the analysis, a statistically significant positive correlation was found between the presence of deviations in the coagulation profile and the development of incomplete closure of macular holes after surgery using platelet-rich autologous plasma (p < 0,001). A more detailed study of the relationship between deviations in the activity of individual components of autologous plasma and the risks of incomplete macular hole closure may serve as a basis for further research and the development of models for predicting surgical treatment outcomes.
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Introduction. The application of platelet-rich autologous plasma has become widely used in vitreoretinal surgery for full-thickness macular hole (FTMH) due to its effectiveness. However, statistical studies show that incomplete macular hole closure occurs in 10% of cases post-surgery. Currently, there are no methods for preoperative prediction of surgical outcomes for FTMH patients. Research highlights the active role of plasma components in neuroepithelial defect closure and macular profile restoration. Therefore, it is reasonable to hypothesize a relationship between coagulation system abnormalities and the development of incomplete FTMH closure when using platelet-rich plasma.
Objective. To evaluate the relationship between the state of the patient's coagulation system and the outcome of surgical treatment for FTMH following vitreoretinal intervention with platelet-rich autologous plasma.
Materials and Methods. A retrospective cohort study was conducted involving 75 patients (75 eyes) with primary FTMH. All underwent minimally invasive subtotal vitrectomy, epiretinal membrane and internal limiting membrane removal, platelet-rich plasma application, and air tamponade. Patients were divided into two groups: the main group (n = 34), which included patients with elevated or decreased coagulogram values prior to surgery, and the control group (n = 41), consisting of patients with coagulogram values within reference ranges. The average macular hole diameter in the main and control groups was 755.50 ± 326.47 μm (range: 339–1829 μm) and 740.44 ± 252.54 μm (range: 353–1579 μm), respectively. Statistical analysis was performed using StatTech software version 4.0.7 (LLC "StatTech", Russia). Fisher's exact test was applied to assess relationships between categorical data.
Results. Comparison of surgical outcomes revealed that incomplete macular hole closure was statistically more frequent among patients with coagulogram abnormalities compared to those in the control group (p < 0.001). A total of 15 cases of incomplete closure were identified: 13 cases (86.7%) involved patients with coagulogram abnormalities, while only 2 cases (13.3%) had reference-range coagulogram values.
Conclusion. This study identified a statistically significant relationship between coagulogram abnormalities and incomplete macular hole closure when using platelet-rich plasma (p < 0.001). Further investigation into specific plasma component activity and its impact on FTMH closure risks may serve as a basis for future research and predictive model development for surgical outcomes.
About the authors
Mikhail Vladimirovich Gusakov
Moscow City Ophthalmological Center, S.P. Botkin Hospital;Department of Ophthalmology, Russian Medical Academy of Continuous Professional Education
Email: gmiklv@gmail.com
ORCID iD: 0000-0002-4447-5919
SPIN-code: 8949-9300
clinical resident
Russian Federation, 125284, Moscow, 2nd Botkinsky pr-d, 5; 123001, Moscow, 7 Mamonovsky Lane, Ophthalmological Clinical HospitalSergey Alexandrovich Kochergin
Moscow City Ophthalmological Center, S.P. Botkin Hospital; Department of Ophthalmology, Russian Medical Academy of Continuous Professional Education
Email: prokochergin@rambler.ru
ORCID iD: 0009-0002-6223-2010
ophthalmologist; Professor of the Department of Ophthalmology Russian Medical Academy of Continuous Professional Education, Moscow, Russian Federation; Doctor of Sciences in Medicine
Russian Federation, 125284, Moscow, 2nd Botkinsky pr-d, 5; 123001, Moscow, 7 Mamonovsky Lane, Ophthalmological Clinical HospitalAlexey Alexandrovich Ovsyanko
Moscow City Ophthalmological Center, S.P. Botkin Hospital; Department of Ophthalmology, Russian Medical Academy of Continuous Professional Education
Author for correspondence.
Email: ovsyanko.a@gmail.com
ORCID iD: 0009-0006-8262-5427
SPIN-code: 6477-2911
Head of ophthalmological department №60 Moscow City Ophthalmological Center, S.P. Botkin Hospital; assistant of the Department of Ophthalmology Russian Medical Academy of Continuous Professional Education, Moscow, Russian Federation; PhD in Medicine
Russian Federation, 125284, Moscow, 2nd Botkinsky pr-d, 5; 123001, Moscow, 7 Mamonovsky Lane, Ophthalmological Clinical HospitalReferences
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