The object: prolìferative diabetic retinopathy (PDRP). Purpose: to increase the efficiency of the surgical treatment of patients with PDRP by the study of the early implementation of ìntravìtreal intervention using research of pathogenetic role of neurotrofìc factors of the functional condition of the retina and the optic nerve (ON) and the development of prediction model of postoperative visual acuity. Methods: ophthalmic (measurement of visual acuity, bìomìcroscopy, oftalmoscopy, tonometry). Immunological (determination of content in vitreous body the level of the brain derivated neurotrophic factor in (BDNF) and pigment epithelium derivated factor (PEDF). Electrophysiological (electroretinogram (ERG) scotopìc, fotopìc, rhythmic, oscilatory potentials (OP) and standard combined, visual evoked potentials (VEP) on flash 2 Hz and 12 Hz and the pattern of 1 ° and 0 ° 15). Statistics and graphics. It was shown that the level of BDNF in the vitreous humor lower than 11,42 pg/ml, accompanied by a 2,3 times decrease in the functional activity of the visual analyzer, according to the visual evoked potential (VEP) data of the 1° pattern and the zone of the visual cortex responsible for the macular area in 2,5 times according to the VEP of the 0º15` pattern. It was shown, when the level PEDF in the vitreous is lower than 3,12 ng / ml, suffer the most bipolar cells, amacrine cells and Mueller cells which is confirmed by an increase in 2,6 times the latency and a decrease in 3,4 of the wave "b" amplitude photopic ERG, as well as an increase in the latency of both the negative and positive peaks of the oscillator potentials in 5 times with a decrease in their amplitude in 7 times.The occurrence of partial atrophy of ON after intravitreal interventions in patients with PDRP is 56,1% of cases after 2 months and does not change one year after the intervention, the occurrence of partial atrophy of ON is higher in patients with TrDM - 37.1% compared with patients with only VH - 19.0% of cases.A forecast model was elaborated according to which the presence of the following factors: the duration of diabetes mellitus (DM) over 15 years, the duration of the proliferative process over 2 years, subcompensated diabetes, phosphen lability of less than 35 Hz, the initial height of the tractional detachment in the macula higher than 800 microns, prevents achievement of visual acuity above 0.1 after intravitreal intervention in patients with PDRP.On the basis of the assessment of the functional state of the retina and the ON using the data of the VEP and the electroretinogram (ERG) complex, early and long-term follow-up of it is recomended for early implementation of intravitreal intervention (with macula-on before the operation), which allows stabilizing both proliferative changes in the eye and neurodystrophic processes of retina and ON in PDRD patients during the year of follow-up. The results were implemented in clinical practice in “Filatov Institute of Eye Diseases and Tissue therapy NAMS of Ukraine and in the clinic of ophthalmology Military medical clinical centre of South region, Odesa.
