Kustryn T. Optimization of treatment of patients with serous detachment of retinal pigment epithelium associated with age-related macular degeneration

Object of investigation: age-related macular degeneration (AMD). The aim of study was to evaluate the effect of triamcinolone acetonide (TA) on the structural and functional retinal pigment epithelial features of patients with transudative (serous) of retinal pigment epithelial detachment (PED) associated with AMD throughout the long-term follow-up period. Methods: visual acuity test, ophthalmoscopy, measure of intraocular pressure, ocular imaging with color fundus photography, long-wave fundusgraphy, fluorescein angiography and optical coherence tomography of macula. For the first time established that that the use of triamcinolone acetonide inhibits the formation of a choroidal neovascularization (CNV) for 2 years in patients with serous PED associated with AMD in comparison with the natural course. Augmented scientific data that the anatomical and morphological parameters of serous PED (height and length of the PED) do not affect the incidence of CNV. For the first time established that the restoration of retinal architectonics of serous PED with AMD achieves in 37% of eyes treated with TA. Augmented scientific data that that TA is a protector for the Bruch's membrane and retinal pigment epithelial (RPE) in patients with serous PED associated with AMD and prevents of RPE tear over the 36-month follow-up period. Established that TA promotes to remaine stable of visual acuity in patients with serous PED associated with AMD. Developed and offered a new method of treatment of patients with serous PED associated with AMD, which consists of subtenon administration of 0.5 ml (40 mg) of TA and repeat injection was made at 3 months after previous injection if no positive dynamics of structural finding. Established that that the results of treatment of patients with serous PED associated with AMD depend on the initial size of serous PED, and not of the administration way of TA. Implementation into practice. The main data of the work are introduced into clinical practice in department of inflammatory pathology of the eye SI "Institute of eye diseases and tissue therapy named by V. P. Filatov of NAMS of Ukraine", department of vitreoretinal and laser microsurgery SI "Institute of eye diseases and tissue therapy named by V. P. Filatov of NAMS of Ukraine", department of laser microsurgery of eye diseases "Institute of eye diseases and tissue therapy named by V. P. Filatov of NAMS of Ukraine", department of ophthalmology of Zakarpatskiy Regional Clinical Hospital by A. Novak, department of ophthalmology of Kirovograd Regional Hospital, department of eye microsurgery of MTPI «Chernihiv Regional Clinical Hospital», LLC "Institute of Medical Innovations - Medical Center «Oko», Chernivtsi. The results of the work were introduced into the educational process at the Department of Otorhinolaryngology with Ophthalmology of the HSEI of Ukraine "Ukrainian Medical Dental Academy" Poltava.