ophthalmologyОфтальмологияOphthalmology in Russia1816-50952500-0845Ophthalmology10.18008/1816-5095-2021-3S-718-726ophthalmology-1649Research ArticleСтатьиРоль витрэктомии в лечении диабетической ретинопатииRole of Vitrectomy in the Treatment of Diabetic Retinopathyhttps://orcid.org/0000-0003-4757-5584ПетрачковД. В.PetrachkovD. V.

Петрачков Денис Валерьевич, кандидат медицинских наук, заведующий отделом «Инновационные витреоретинальные технологии»

ул. Россолимо, 11а, б, Москва, 119021

Petrachkov Denis V., PhD, head of the Department of innovative vitreoretinal technologies

Rossolimo str., 11A,B, Moscow, 119021

https://orcid.org/0000-0003-3254-4451КоробовЕ. Н.KorobovE. N.

Коробов Егор Николаевич, кандидат медицинских наук, младший научный сотрудник отдела «Инновационные витреоретинальные технологии»

ул. Россолимо, 11а, б, Москва, 119021

Korobov Egor N., PhD, junior researcher of the Department of innovative vitreoretinal technologies

Rossolimo str., 11A,B, Moscow, 119021

egorkorobov1991@mail.ruhttps://orcid.org/0000-0002-9158-697XАржухановД. Д.ArzhukhanovD. D.

Аржуханов Дмитрий Данильевич, аспирант отдела «Инновационные витреоретинальные технологии»

ул. Россолимо, 11а, б, Москва, 119021

Arzhukhanov Dmitriy D., postgraduate of the Department of innovative vitreoretinal technologies

Rossolimo str., 11A,B, Moscow, 119021

ФГБНУ «Научно-исследовательский институт глазных болезней»РоссияResearch Institute of Eye DiseasesRussian Federation202122102021183S718726Copyright © Петрачков Д.В., Коробов Е.Н., Аржуханов Д.Д., 20212021Петрачков Д.В., Коробов Е.Н., Аржуханов Д.Д.Petrachkov D.V., Korobov E.N., Arzhukhanov D.D.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.ophthalmojournal.com/opht/article/view/1649

Диабетическая ретинопатия представляет собой медико-социальную проблему из-за высокого риска инвалидизации пациентов работоспособного возраста. Существуют три основных патогенетически обоснованных метода лечения осложнений диабетической ретинопатии: лазерная коагуляция сетчатки, фармакотерапия (интравитреальные инъекции ингибиторов ангиогенеза, стероидных препаратов) и витреоретинальная хирургия. В настоящее время отсутствует четкое понимание своевременности проведения витрэктомии, большинство руководств рекомендует прибегать к витреоретинальной хирургии только при развитии осложнений пролиферативной стадии диабетической ретинопатии, однако к этому моменту нередко уже происходит стойкая утрата зрения. Стремительные темпы развития витреоретинальной хирургии позволяют проводить оперативное вмешательство в более ранние сроки и предотвратить потерю зрительных функций. Таким образом, появились предпосылки к определению показаний к проактивному оперативному лечению осложнений диабетической ретинопатии.

Diabetic retinopathy (DR) is a socially significant disease with a steady tendency to increase, in which there is a high risk of disability due to persistent loss of vision. There are three main pathogenetically substantiated methods of DR treatment: laser coagulation of the retina; intravitreal injections of VEGF inhibitors, steroid drugs; vitreoretinal surgery. In the later stages of DR, vitrectomy is the main method of its complications treating, but there is no clear understanding of the timeliness of this operation. The analysis of the results of original research on this problem is carried out. It has been shown that with the advent of new instruments, modified vitrector, operating microscopes, viewing systems and vitreoretinal combines, vitrectomy led to a change in the paradigm of DR treatment. These advances have resulted in better surgical control and greater precision, while at the same time shorter surgical times and fewer surgical complications. There is a tendency to perform vitrectomy at earlier stages of DR, which has a pathogenetic rationale. This could be a leap forward in the treatment of DR as a preventive measure against the development of proliferative DR.

диабетическая ретинопатиянепролиферативная диабетическая ретинопатияпролиферативная диабетическая ретинопатиядиабетический макулярный отекДМОнеоваскуляризация сетчаткинеоваскуляризация зрительного нервавитрэктомиявитреоретинальная хирургиялазерная коагуляция сетчаткиэндотелиальный фактор роста сосудовVEGFинтравитреальные инъекциианти-VEGF-терапияdiabetic retinopathynonproliferative diabetic retinopathyproliferative diabetic retinopathydiabetic macular edemaDMEneovascularization of the retinaneovascularization of the optic nervevitrectomyvitreoretinal surgerylaser coagulation of the retinaendothelial growth factorVEGFanti-VEGF therapyReferencesInternational Diabetes Federation. IDF Diabetes Atlas. 9th ed; 2019.International Diabetes Federation. IDF Diabetes Atlas. 9th ed; 2019.Lee R., Wong T.Y., Sabanayagam C. Epidemiology of diabetic retinopathy, diabetic macular edema and related vision loss. Eye Vis (Lond). 2015;2:17. DOI: 10.1186/s40662-015-0026-2Lee R., Wong T.Y., Sabanayagam C. 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The authors declare that there are no conflicts of interest present.