Optic Nerve Blood Flow Measurement

[Biomechanics of diabetic vitreopapillary traction syndrome]

Diabetic vitreopapillary traction syndrome (VPT) is a variant of diabetic retinopathy (DR) that can lead to vision loss in advanced stages. This review reports on the biomechanics of the vitreous in the pathogenesis of proliferative DR, in particular diabetic VPT. The article analyzes and summarizes literature data, presents the views of different authors on this problem, and provides the results of Russian and foreign scientific research on this pathology. It is concluded that further research in this area can lead to a significant improvement in the results of therapy, timely diagnosis, and preservation of vision in patients with DR.

[Vitreopapillary traction syndrome in patients with proliferative diabetic retinopathy]

PURPOSE

To draw attention to characteristic features of the clinical manifestations of vitreopapillary traction syndrome (VPTS) in patients with proliferative diabetic retinopathy (PDR), to determine the role of the biomechanical factor in pathophysiology of this syndrome, and to evaluate the results of surgical treatment.

MATERIAL AND METHODS

The features of clinical manifestations of VPTS of 50 patients with PDR who were treated at the ophthalmology center of the National Medical and Surgical Center named after N.I. Pirogov in the period from 2014 to 2018 were analyzed retrospectively. The preoperative study included standard ophthalmological examination methods, as well as ultrasound B-scan, computer perimetry, optical coherence tomography (OCT), fluorescence angiography (FA) in the first two years of observation. The comparison group consisted of 45 patients with PDR without signs of VPTS, who were treated in the center during the same period of time.

RESULTS

The obtained results suggest that the pathophysiology of VPTS in diabetes mellitus has distinctive features and is determined by the topography of the peripapillary zone, as well as choroidal vascularization of the optic nerve head; biomechanical factor plays an important role in the formation of a fibrovascular stem (FVS) in VPTS.

CONCLUSION

The results indicate that patients with VPTS have a worse prognosis for achieving best corrected visual acuity (BCVA) after surgery than patients without signs of VPTS. Correct and timely diagnosis, early treatment by vitreoretinal surgery give a greater chance of achieving higher BCVA in the postoperative period in this category of patients.