No abstract

Purpose. To evaluate the morphological and functional parameters of the retina after subretinal administration of recombinant prourokinase followed by endovitreal tamponade with an air-gas mixture without vitrectomy in comparison with antivasoproliferative therapy in patients with subfoveal hemorrhages. Material and methods. Patients of the first group at the 1 st stage underwent two-port 27G surgery with controlled subretinal injection of a solution of recombinant prourokinase 500 IU through a 38G cannula with tamponade of ⅕ of the volume of the vitreal cavity with gas. At 2 nd stage, therapy with anti-vasoproliferative drugs was prescribed according to the treat and extend regimen. Patients in the control group received antivasoproliferative therapy as the main treatment. Results. In the 1 st group, there was a trend towards an increase in maximum corrected visual acuity (BCV) throughout the entire observation period: on the 14th day after the 1 st stage of treatment, it was 0.18 ± 0.05 (p < 0.05 compared to before treatment), after 3 loading injections – 0.3 ± 0.1, while there was an increase in photosensitivity values up to 4.7 ± 2.2 dB (p < 0.05 in comparison with the values before treatment) and up to 12.6 ± 4.6 in the 1 st group (p < 0.05 in comparison with the indicators before treatment, the indicators of the 2 nd group), respectively. An inverse correlation of functional parameters was noted against the background of depression of the central retinal thickness up to 222.0 ± 60.7µm and the height of the neovascular membrane up to 72.0 ± 23.0 at the end of the observation. Conclusion. The use of subretinal administration of recombinant prourokinase followed by endovitreal tamponade with an air-gas mixture without vitrectomy demonstrates an increase in BCVA with a decrease in the area of absolute scotoma with an increase in the overall photosensitivity of the macular zone against the background of improved anatomical parameters. Timely appointment of antivasoproliferative therapy in the postoperative period ensures the preservation of the morphofunctional results achieved after surgery. Keywords: submacular hemorrhage, tissue plasminogen activator, pneumodislocation.