Chui K. Optimization of diagnosis and treatment of branch retinal vein occlusion

The thesis is devoted to the problem оf optimization of diagnosis and treatment of macular oedema (MO) secondary to branch retinal vein occlusion (BRVO) by determining the content of vascular endothelial growth factor (VEGF) in the patient's tear fluid and studying its diagnostic significance. The dependence of the effectiveness of anti-VEGF-therapy on the baseline local immune background in patients with MO secondary to BRVO was studied. It has been found that 61% of patients with MO secondary to BRVO had the increased baseline level of VEGF-A in the tear fluid of the affected eye. The dependence of anti-VEGF-therapy results on the local immune background parameters of the healthy pair eye in patients with MO secondary to BRVO was established. The positive result was found in patients with the high (more than 1300 pg/ml) and normal (from 700 to 1300 pg/ml) baseline VEGF-A level in the tear fluid of the eye affected with the BRVO. The positive results of anti-VEGF-therapy was found in patients with the low baseline VEGF-A level (below 700 pg/ml) in the tear fluid of the affected eye, however, when it exceeded VEGF-A level in the tear fluid of the healthy pair eye. Thus, the diagnostic significance of the baseline level of VEGF-A in the tear fluid of the healthy pair eye as a background indicator of the local immune status of the eyes of each individual patient with MO secondary to BRVO was clarified. The negative results of anti-VEGF-therapy was found in patients with the low baseline VEGF-A level (below 700 pg/ml) in the tear fluid of the affected eye, however, when it did not exceed the VEGF-A level in the tear fluid of the healthy pair eye. All this indicates the expediency of choosing alternative treatment methods for anti-VEGF-therapy, such as retinal laser coagulation or the combination of intravitreal corticosteroids and retinal laser coagulation.