Dynamics of rheological and biochemical blood parameters of patients with an intermediate stage of the dry form of age-related macular degeneration before and after serum cascade filtration

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Abstract

BACKGROUND: One of the socially significant ophthalmic diseases is the dry form of the age-related macular degeneration, the key feature of which consists in a slowly progressing damage to the pigment epithelium and the formation of drusen. However, the basic mechanisms of pathogenesis are still not completely clear nowadays.

AIM: The aim is, using the data of OCT, OCT-angiography and visometry, to study the dynamics of structural and functional parameters of the macular area, as well as the dynamics of rheological and biochemical blood parameters in patients with an intermediate stage of the dry form of age-related macular degeneration before and after the use of serum cascade filtration.

MATERIALS AND METHODS: The study included 63 patients (94 eyes) with an intermediate stage of the dry form of age-related macular degeneration. Patients were randomly separated into two groups. The first (main) group consisted of 34 patients (52 eyes), in whom serum cascade filtration was performed; the second group (control) group included 29 patients (42 eyes) who did not receive any specific treatment. In patients of the main group, before and after the serum cascade filtration course (1 month after the start of follow-up), in 6 and 12 months, in addition to standard ophthalmological examination, as an indicator of the efficacy of performed serum cascade filtration, the ultrasound triplex scanning in color Doppler mapping mode with an assessment of blood flow velocity in the posterior short ciliary arteries, Fourier IR spectroscopy, and the testing of the serum and blood viscosity were performed. Patients in the control group also underwent a similar examination at 1, 6, 12 months after the start of follow-up.

RESULTS: According to optical coherence tomography, optical coherence tomography-angiography and visometry data, we found a positive dynamics of structural and functional parameters of the macular retina and an improvement in blood rheological parameters with an increase in microcirculation indices against the background of the serum cascade filtration use in treatment of patients with an intermediate stage of the dry form of age-related macular degeneration. At the same time, a statistically significant difference between the two groups begins at 1 month and persists for 12 months of follow-up, being an evidence of the stabilization of the pathological process.

CONCLUSIONS: This study showed that after the serum cascade filtration in patients with an intermediate stage of the dry form of age-related macular degeneration, against the background of an improvement in blood rheological and biochemical parameters, there was an improvement in structural and functional parameters of the macular area, which consisted in a decrease of the volume of the drusenoid retinal pigment epithelium detachment and in a visual acuity amelioration.

About the authors

Aleksey N. Kulikov

Kirov Military Medical Academy

Email: alexey.kulikov@mail.ru
ORCID iD: 0000-0002-5274-6993
SPIN-code: 6440-7706

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Saint Petersburg

Andrey N. Belskikh

Kirov Military Medical Academy

Email: d0c62@mail.ru
ORCID iD: 0000-0002-0421-3797
SPIN-code: 7764-0930

MD, Dr. Sci. (Medicine), Professor, Corresponding Member of the Russian Academy of Sciences

Russian Federation, Saint Petersburg

Aleksandr A. Volozhev

Kirov Military Medical Academy

Author for correspondence.
Email: aleksandr-volozh@mail.ru
ORCID iD: 0000-0001-5446-5063
SPIN-code: 1269-2220
Russian Federation, Saint Petersburg

Aleksandr V. Podshivalov

Saint Petersburg National Research University of Information Technologies, Mechanics and Optics

Email: podshivalov@itmo.ru
ORCID iD: 0000-0002-7581-8582
SPIN-code: 7008-7636

Cand. Sci. (Chemistry)

Russian Federation, Saint Petersburg

Vera E. Sitnikova

Saint Petersburg National Research University of Information Technologies, Mechanics and Optics

Email: kresenka@mail.ru
ORCID iD: 0000-0003-4753-976X
SPIN-code: 1003-2636

Cand. Sci. (Chemistry), Assistant Professor

Russian Federation, Saint Petersburg

Dmitrii S. Maltsev

Kirov Military Medical Academy

Email: glaz.med@yandex.ru
ORCID iD: 0000-0001-6598-3982
SPIN-code: 4903-2333

MD, Dr. Sci. (Medicine)

Russian Federation, Saint Petersburg

Svetlana E. Bednova

Kirov Military Medical Academy

Email: sebednova@mail.ru
ORCID iD: 0009-0006-3960-7346
Russian Federation, Saint Petersburg

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Supplementary files

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2. Fig. 1. Representative example of the drusenoid retinal pigment epithelium detachment area calculation in a patient with the dry form of age-related macular degeneration. Structural en face scan projection of the “HD Angio Retina 6 mm” protocol

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3. Fig. 2. Representative example of the result of the Fourier IR spectroscopy analysis in a patient with the dry form of age-related macular degeneration

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4. Fig. 3. Representative example of the result of an analysis of the blood serum viscosity in a patient with the dry form of age-related macular degeneration

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5. Fig. 4. Example of structural and anatomical changes dynamics after the use of the serum cascade filtration in patients with the dry form of age-related macular degeneration according to the OCT and OCT-A data during the study: a — start of the follow-up; b — in 1 month; c — 6 months; d — 12 months

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6. Fig. 5. Dynamics of the drusenoid retinal pigment epithelium detachment height in studied groups

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7. Fig. 6. Dynamics of the drusenoid retinal pigment epithelium detachment area in studied groups

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8. Fig. 7. Dynamics of visual acuity in studied groups: a — using the ETDRS chart; b — using the Golovin–Sivtsev chart

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