Aim:

To compare the degree of neuroretinal degeneration by the complex of electrophysiological methods, pattern visual evoked potentials (PVEP) in patients with proliferative diabetic retinopathy (PDRP) who underwent vitrectomy due to only vitreous hemorrhage and tractional retinal detachment.

Material & Methods:

We examined 43 patients with PDRP (43 eyes) in terms of 2 months after vitrectomy. The study included patients with positive anatomic result, the absence of residual macular edema by optical coherence tomography investigations and full transparency of optic media. Indication for vitrectomy in 23 eyes (53,5%) was vitreous hemorrhage without epiretinal tissue, 20 eyes (46,5%) partial vitreous hemorrhage with epiretinal membranes and tractional retinal detachment threatening or involved the macula. Initial visual acuity in patients with only vitreous hemorrhage was from light perception to 0,03, and in patients with tractional retinal detachment from 0,01 to 0,3 and was significantly higher than in patients with vitreous hemorrhage (χ2. = 5,18; p = 0,02).

Results:

In group of patients only with vitreous hemorrhage visual acuity in 4 eyes (17,4 %) was from 0,05 to 0,1, in 10 eyes (43,5%) from 0,12 to 0,3 and 9 eyes (39,1%) had visual acuity from 0,35 to 1,0. In patients with tractional retinal detachment, visual acuity was as follows: from 0,05 to 0,1 – 10 eyes (50,0%) from 0,12 to 0,3 – 6 eyes (30,0%) and from 0,35 to 1,0 – 4 eyes (20,0%) and was significantly lower than in patients with only vitreous hemorrhage (χ2 = 5,07; p = 0,02). Bioelectric activity of photoreceptor complex and middle layers of the retina in the macular area and on the periphery according to electrophysiological investigations in patients with only vitreous hemorrhage was reduced in 3,1 times in compare with normal indexes, and in patients with tractional retinal detachment in 5,1 times. The decreasing of electrophysiological indexes in patients with tractional retinal detachment was significantly lower (χ2 = 4,68; p = 0.03). Ischemia of choriocapillaris layer was observed more frequently in patients with tractional retinal detachment – 18 eyes (90,0%) versus 16 eyes (69,6%) in patients with only vitreous hemorrhage. The data of PVEP testified to a more marked decrease in the bioelectric activity of the visual cortex in patients with tractional retinal detachment is not less than 1,2 times as pattern 1° and 0°15 amplitude wave R100 compared with patients with only vitreous hemorrhage.

Conclusion:

Patients of PDRP, who underwent vitrectomy with the removal of epiretinal tissue, have more severe neurodegenerative processes in the retina and significantly reduced the bioelectrical activity of the visual cortex in compare with patients who have proliferative process in an earlier stage.

Contact Details:

Email: alputienko@yandex.ru
Cell Phone: /+380506461192