Ivanchenko A. Improving the clinical effectiveness of surgical treatment of regmatogenic retinal detachment by assessing immunological and anatomical morphological parameters

Improving the clinical effectiveness of surgical treatment of regmatogenic retinal detachment by assessing immunological and anatomical morphological parameters. - Qualification scientific work on the rights of the manuscript. The dissertation is dedicated to the problem of improving surgical functional outcomes in patients with regmatogenic retinal detachment after vitrectomy by studying changes in the microcirculatory bed and their relationship with angiopoietin-2 in the vitreous. For the first time, the level of angiopoietin-2 in patients with RRD and its effect on the macular area FAZ, parafoveal density of superficial capillary plexus and parafoveal density of deep capillary plexus were determined. In patients without macular detachment, this indicator ranged from 84.50 pg/ml to 268.3 pg/ml and averaged 129.7 ± 51.99 pg/ml, in patients with macular detachment from 103.7 pg/ml to 2065 pg/ml and averaged 693.8 ± 334.7 pg/ml. The knowledge about the morphology and vascular architecture of the retina in patients after surgical treatment of regmatogenic retinal detachment with and without macular detachment was supplemented. The scientific data on the existence of a link between changes in the microcirculatory bed and functional outcomes in the postoperative period were confirmed. The knowledge about the possible causes of incomplete visual acuity recovery in patients after surgical treatment for regmatogenous retinal detachment has been deepened. The data obtained expand the understanding of incomplete visual acuity recovery in patients operated for RRD. The results of this study allow us to predict the possible visual acuity of patients after surgical treatment and allow the doctor to improve functional outcomes after RRD. Angiopoietin-2 levels can be considered as a criterion for predicting the outcome of surgical treatment of regmatogenous retinal detachment and the need for additional medical correction of the detected vascular disorders. Practical significance of the results. The theoretical provisions and practical recommendations of the work are included in the program of lectures and practical classes of the Department of Otorhinolaryngology and Ophthalmology of the Poltava State Medical University and implemented in the work of the ophthalmology department of the Poltava Regional Clinical Hospital, the medical center "Svitoglyad", the medical center "IRMED" and confirmed by the "Acts of Implementation" Key words: regmatogenic retinal detachment, optical coherence tomography-angiography, OCT, gas tamponade, macular detachment, macula, macula-on, macula-off, vitreoretinal interventions, surgical treatment, angiopoietin-2, visual acuity, functional outcomes.