Diana Chichur, Andrej Sergienko (Kyiv, Ukraine)

Advantages:

The thesis is devoted to improving efficacy of treatment of rhegmatogenous retinal detachment (RRD) patients, aimed to prevent the disease relapse and its development in the fellow eye by using a modified immunosuppressive therapy method, by studying autoimmune process activity in patients with different disease course.

Methods:

80 patients suffering from bilateral RRD were included in the study.

Effectiveness / Safety:

Two types of bilateral RRD clinical course were distinguished from clinical assessment: type I ˆ favorable, observed in 13.7% of the cases, manifested through its tendency for simultaneous affection of both eyes, absence of vitreoretinal traction, low relapse rate, and high effectiveness of extrascleral sealing reaching 100%; type II ˆ unfavorable, observed in 86.3% of the cases, manifested through successive lesion of eyes, pronounced vitreoretinal traction, frequent use of endovitreal surgery, and decrease of surgical treatment efficacy to 73.7 %. Excessive activation of autoimmune processes and their maintenance has been found to be one of pathogenetic mechanisms of recurrent RRD and bilateral RRD development in 80% of the cases. Efficacy of the suggested treatment scheme was 82.0%: relapse rate in unilateral RRD patients was decreased from 35.7% to 4.2%, and the same parameter in BRRD patients was decreased from 76.9% to 18.8%.

Take home message:

Application of steroids (both systemic and topical) in the treatment of patients with high levels of circulating autoantibodies to ocular tissues (20.0 U and higher) prevents realization of autoimmune cytotoxic reactions, thus decreasing the risk of relapse and RRD development on the fellow eye.