Молодежный инновационный вестник

2415-7805

Федеральное государственное бюджетное образовательное учреждение высшего образования "Воронежский государственный медицинский университет имени Н.Н. Бурденко" Министерства здравоохранения Российской Федерации

10783

Conference Proceedings

Analysis of the relationship between coagulogram deviations and development of recurrent full-thickness macular holes after surgical treatment with autologous platelet-rich plasma

Gusakov

Mikhail Vladimirovich

clinical residentgmiklv@gmail.comhttps://orcid.org/0000-0002-4447-5919Kochergin

Sergey Alexandrovich

ophthalmologist; Professor of the Department of Ophthalmology Russian Medical Academy of Continuous Professional Education, Moscow, Russian Federation; Doctor of Sciences in Medicineprokochergin@rambler.ruhttps://orcid.org/0009-0002-6223-2010Ovsyanko

Alexey Alexandrovich

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 Medicineovsyanko.a@gmail.comhttps://orcid.org/0009-0006-8262-5427

Moscow City Ophthalmological Center, S.P. Botkin HospitalDepartment of Ophthalmology, Russian Medical Academy of Continuous Professional Education

04112025

1423940

31032025

08042025

2025

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.

full-thickness macular holevitreoretinal surgeryautologous platelet-rich plasma

сквозной макулярный разрыввитреоретинальная хирургияаутоплазма обогащенная тромбоцитами

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 m (range: 3391829 m) and 740.44 252.54 m (range: 3531579 m), 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.

Parisi G, Gelormini F, Ricardi F, et al. Platelet rich plasma for primary macular hole: A case series. Eur J Ophthalmol. 2024 Nov;34(6):1984-1990. doi: 10.1177/11206721241234419. Epub 2024 Feb 29. PMID: 38425189.

Romano MR, Rossi T, Borgia A, et al. Management of refractory and recurrent macular holes: A comprehensive review. Surv Ophthalmol. 2022 Jul-Aug;67(4):908-931. doi: 10.1016/j.survophthal.2022.01.006. Epub 2022 Jan 31. PMID: 35101550.

Шамкин С.С., Субботина С.Н., Степанянц А.Б. Механизмы закрытия центральных и периферических разрывов сетчатки при использовании PRP плазмы // Уральский медицинский журнал. 2023. №22(5): 115-122. https://doi.org/10.52420/2071-5943-2023-22-5-115-122