urmjУральский медицинский журналUral Medical Journal2949-4389Ural State Medical University10.52420/umj.24.2.44EAERCOurmj-1776Research ArticleОригинальные статьи | Original articlesOriginal articlesРезультаты лечения диабетического макулярного отека в зависимости от соблюдения режима антиангиогенной терапии в реальной клинической практикеResults of Diabetic Macular Edema Treatment Dependence on Adherence to Antiangiogenic Therapy in Real Clinical Practicehttps://orcid.org/0000-0002-1799-211XДроздоваЕ. А.DrozdovaE. A.

Елена Александровна Дроздова — доктор медицинских наук, профессор, заведующий кафедрой офтальмологии, Южно‑Уральский государственный медицинский университет, Челябинск, Россия; офтальмолог, Городская клиническая больница № 11.

Челябинск

Elena A. Drozdova — Doctor of Sciences (Medicine), Professor, Head of the Department of Ophthalmology, South Ural SMU; Ophthalmologist, City Clinical Hospital No. 11.

Chelyabinsk

dhelena2006@yandex.ruДашенкоК. Н.DashenkoK. N.

Ксения Николаевна Дашенко — кандидат медицинских наук, ассистент кафедры офтальмологии, Южно‑Уральский ГМУ; офтальмолог, Городская клиническая больница № 11

Челябинск

Ksenia N. Dashenko — Candidate of Sciences (Medicine), Assistant of the Department of Ophthalmology, South Ural SMU; Ophthalmologist, City Clinical Hospital No. 11.

Chelyabinsk

k.dashenko@mail.ruКузнецовА. С.KuznetsovA. S.

Андрей Сергеевич Кузнецов — старший лаборант кафедры офтальмологии, Южно‑Уральский ГМУ; офтальмолог, Городская клиническая больница № 11

Челябинск

Andrey S. Kuznetsov — Senior Laboratory Technician of the Department of Ophthalmology, South Ural SMU; Ophthalmologist, City Clinical Hospital No. 11.

Chelyabinsk

andrey_vr@inbox.ruГезибейковТ. Т.GezibeykovT. T.

Теодор Тариелович Гезибейков — аспирант кафедры офтальмологии, Южно‑Уральский ГМУ; офтальмолог, Городская клиническая больница № 11.

Челябинск

Teodor T. Gezibeykov — Postgraduate Student of the Department of Ophthalmology, South Ural SMU; Ophthalmologist, City Clinical Hospital No. 11.

Chelyabinsk

gezibejkov@mail.ruЮжно‑Уральский государственный медицинский университет; Городская клиническая больница № 11РоссияSouth Ural State Medical University; City Clinical Hospital No. 11Russian Federation20250505202524244–55Copyright © Дроздова Е.А., Дашенко К.Н., Кузнецов А.С., Гезибейков Т.Т., 20252025Дроздова Е.А., Дашенко К.Н., Кузнецов А.С., Гезибейков Т.Т.Drozdova E.A., Dashenko K.N., Kuznetsov A.S., Gezibeykov T.T.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.umjusmu.ru/jour/article/view/1776Актуальность

Актуальность. Сахарный диабет (СД) — это хроническое заболевание, которое может привести к различным осложнениям, в т. ч. диабетической ретинопатии (ДР; может проявляться более чем у 30 % больных диабетом и часто осложняется диабетическим макулярным отеком (ДМО)). ДМО приводит к потере центрального зрения и снижает качество жизни. Существует несколько методов лечения ДР, включая лазерную коагуляцию сетчатки, интравитреальные инъекции антивазопролиферативных препаратов (анти-VEGF) и импланта дексаметазона, витреоретинальную хирургию.

Цель работы — оценить долгосрочные результаты лечения ДМО в зависимости от соблюдения режима анти-VEGF-терапии в офтальмоэндокринологическом центре Челябинска.

Материалы и методы

Материалы и методы. В исследование включено 76 пациентов с ДМО (23/76 (30,3 %) мужчины, 53/73 (69,7 %) женщины) в возрасте 64,4 [61,8; 70,0] лет. В общей выборке СД 1 типа установлен у 13/76 (17,1 %) пациентов, СД 2 типа — 63/76 (82,9 %); непролиферативная стадия ДР имела место у 51/76 (67,1 %) человека, пролиферативная — 25/76 (32,9 %).

Обсуждение

Обсуждение. Наблюдаются увеличение максимально корригируемой остроты зрения и снижение толщины сетчатки после 3 загрузочных инъекций афлиберцепта. После 5-й инъекции — стабилизация морфометрических и функциональных результатов.

Заключение

Заключение. Результаты проведенного исследования показывают, что эффективность лечения ДМО афлиберцептом достигается при пяти загрузочных инъекциях и регулярной терапии анти-VEGF-препаратом. При нерегулярном введении препарата улучшающий эффект не достигается, что может привести к негативному отношению к лечению и отказу от дальнейшего наблюдения.

Relevance

Relevance. Diabetes mellitus (DM) is a chronic disease that can lead to various complications, one of which is diabetic retinopathy (DR), which can occur in more than 30 % of diabetic patients and diabetic macular edema (DME), the most formidable complication of DR. DME results in loss of central vision and significantly reduces quality of life. There are several treatments for DR including laser retinal photocoagulation, intravitreal injections of antivasoproliferative drugs, dexamethasone implant, and vitreoretinal surgery.

The aim of the work is to evaluate long-term real results of diabetic macular edema treatment depending on adherence to anti-VEGF therapy in the ophthalmoendocrinological centre of Chelyabinsk city.

Materials and methods

Materials and methods. 76 patients with DME (including 23/76 (30.3 %) men, 53/76 (69.7 %) women) aged 64.4 [61.8; 70.0] years. In the total sample of patients, type 1 DM was diagnosed in 13/76 (17.1 %) patients, type 2 DM — in 63/76 (82.9 %) patients; nonproliferative stage of DR occurred in 51/76 (67.1 %), proliferative — in 25/76 (32.9 %) patients.

Discussion

Discussion. There was a significant increase in MCOS and a decrease in retinal thickness after 3 loading injections. Stabilization of morphometric and functional results was observed after the 5th injection.

Conclusion

Conclusion. The study shows that the efficacy of aflibercept treatment for DME is achieved with five loading injections and regular therapy. When the drug is not administered regularly, the improving effect is not achieved, which may lead to a negative attitude to treatment and withdrawal from further follow-up.

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The authors declare that there are no conflicts of interest present.