Dastan Kyrykbayev

Introduction. Neovascular age–related macular degeneration, diabetic macular edema, and macular edema secondary to retinal vein occlusion are leading causes of persistent central vision loss. Faricimab is the first bispecific intravitreal agent targeting both VEGF–A and Ang–2, potentially providing meaningful early anatomical and functional benefits in real–world practice. Aim. To assess the real–world effectiveness and safety of faricimab (6 mg/0.05 mL) in patients with neovascular age–related macular degeneration (nAMD), diabetic macular edema (DME), and macular edema secondary to central retinal vein occlusion (CRVO). Materials and Methods. Twelve treatment–naïve patients who had not previously received intravitreal therapy with vascular endothelial growth factor (VEGF) inhibitors were included: 4 patients in each cohort (nAMD, DME, and CRVO). All patients received four monthly intravitreal injections of faricimab (6 mg), with assessment of best–corrected visual acuity (BCVA) and central retinal thickness (CRT). Results. OCT demonstrated a reduction in the severity of macular edema in all patients across all cohorts after the loading phase. In the overall group, BCVA improved from 0.23 ± 0.22 to 0.56 ± 0.34 (p = 0.016). CRT decreased from 503 ± 129 μm to 328 ± 76 μm (p = 0.003). No serious injection–related complications were observed. Conclusion. After the loading phase, faricimab showed early signs of functional and anatomical improvement with a favorable safety profile. Key words: Wet Macular Degeneration, Macular Edema, Diabetic Retinopathy, Retinal Vein Occlusion, Intraocular Injections. Введение. Неоваскулярная возрастная макулярная дегенерация (нВМД), диабетический макулярный отек (ДМО) и макулярный отек при тромбозе вены сетчатки (ТВС) остаются частыми причинами стойкого снижения центрального зрения и требуют регулярной анти–VEGF терапии. Фарисимаб – первый биспецифический препарат, одновременно блокирующий VEGF–A и Ang–2, что может усилить и стабилизировать анатомо–функциональный ответ в реальной клинической практике. Цель. Оценить эффективность и безопасность Фарисимаба (6 мг/0,05 мл) в реальной клинической практике у пациентов с нВМД, ДМО и макулярным отеком при ТВС. Материалы и методы. В исследовании участвовали 12 пациентов, ранее не получавших интравитреальной терапии ингибиторами фактора роста сосудистого эндотелия: по 4 пациента в каждой когорте (нВМД, ДМО, ТВС). Всем выполнено четыре ежемесячные интравитреальные инъекции Фарисимаба (6 мг) с оценкой максимально корригированной остроты зрения (МКОЗ) и центральной толщины сетчатки (ЦТС). Результаты. По данным ОКТ после загрузочной фазы у всех пациентов во всех когортах отмечено уменьшение выраженности макулярного отека. В общей когорте МКОЗ увеличилась с 0,23 ± 0,22 до 0,56 ± 0,34 (p = 0,016). Центральная толщина сетчатки уменьшилась с 503 ± 129 мкм до 328 ± 76 мкм (p = 0,003). Серьезных осложнений, связанных с инъекциями, не зарегистрировано. Заключение. После загрузочной фазы Фарисимаб продемонстрировал ранние признаки функционального и анатомического улучшения при благоприятном профиле безопасности. Ключевые слова: влажная возрастная макулярная дегенерация, макулярный отек, диабетическая ретинопатия, окклюзия вен сетчатки, внутриглазные инъекции. Кіріспе. Неоваскулярлы жасқа байланысты макулярлық дегенерация, диабеттік макулярлық ісіну және торқабық венасының окклюзиясына байланысты макулярлық ісіну орталық көрудің тұрақты төмендеуінің негізгі себептерінің бірі болып табылады. Фарисимаб – VEGF–A және Ang–2–ні бір мезгілде тежейтін алғашқы биспецификалық препарат, бұл нақты клиникалық тәжірибеде айқын анатомиялық және функционалдық әсер беруі мүмкін. Мақсаты. Неоваскулярлы жасқа байланысты макулярлық дегенерациясы (нЖБМД), диабеттік макулярлық ісінуі (ДМІ) және торқабық венасының тромбозына байланысты макулярлық ісінуі (ТВТ) бар пациенттерде фарисимабтың (6 мг/0,05 мл) тиімділігі мен қауіпсіздігін бағалау. Материалдар мен әдістер. Зерттеуге бұрын тамырлық эндотелий өсу...

Introduction: this study evaluates the impact of pars plana vitrectomy (PPV) combined with internal limiting membrane (ILM) peeling and platelet-rich plasma (PRP) application on anatomical, functional, and quality-of-life (QoL) outcomes in patients with macular holes.Method: prospective cohort study. Tertiary eye care center, January 2021 to December 2023. A total of 155 patients underwent PPV with ILM peeling and PRP. Visual acuity (logMAR), macular hole closure, and QoL were assessed pre- and postoperatively. QoL evaluation used a localized adaptation of the NEI VFQ-25 questionnaire. Anatomical outcomes were measured by Optical Coherence Tomography (OCT).Results: the mean age was 65,90 ± 8,84 years; 38 % were female. The closure rate was 94 %. Visual acuity improved significantly, with average logMAR improving from 0,7 to 0,3 (p < 0,001). QoL scores improved across all domains: visual functioning increased from 55.3 to 85.7, daily activities from 48,2 to 80,4, and psychological well-being from 50,1 to 82,9. Patients reported greater independence and improved ability in activities like reading, recognizing faces, and participating in sports.Conclusion: PPV with ILM peeling and PRP is highly effective for macular holes, yielding strong anatomical and functional outcomes alongside significant QoL enhancements.

Background: There is a lack of research on the clinical characteristics of vitreomacular traction (VMT) in the Central Asian population, which evaluates the visual recovery and macular hole closure outcomes of pars plana vitrectomy (PPV) with membrane peel in this population. Methods: This long-term prospective cohort study, conducted at the Kazakh Eye Research Institute from June 2015 to December 2021 with a follow-up period until December 2022, included 1574 patients (1784 eyes) with VMT syndrome. Among the eyes, 724 (40.58%) had VMT, 620 (34.75%) had a lamellar macular hole (LMH), and 440 (24.66%) had a full-thickness macular hole (FTMH). Results: The FTMH group consisted of small (≤250 μm) holes in 14 (3.2%) eyes, medium (250–400 μm) holes in 79 (17.9%) eyes, and large (>400 μm) holes in 347 (78.9%) eyes. Significant improvements in visual acuity, retinal thickness reduction, and macular hole closure were observed in 98.79% of patients with LMH and 81.14% of patients with FTMH at 1.5 months after surgery. PPV with membrane peel resulted in improved clinical outcomes, including enhanced visual acuity and macular structure. Conclusions: These findings support the existing research indicating the efficacy and relative safety of this surgical approach for VMT, despite the potential risks of postoperative complications.

Introduction: IMH causes loss of central vision and it restricts the activities of a patient, therefore posing a threat to the patient’s quality of life. Modern developments in surgical interventions as well as the organization of medical care enhance the effectiveness of treatment while a detailed analysis of it is needed.Objective: consequently, the purpose of this particular research is to examine organizational medical care among the specified population of patients with IMH, in regard to their quality of life and the efficacy of contemporary treatment regimens.Method: to accomplish this, the current study applied narrative synthesis strategies and reviewed literature on IMH diagnosis, management for surgical solutions, and patient outcomes. This assessment encompassed previous and current therapy methods together with patient enlightenment and follow-up with impact on vision clarity and general quotient.Results: from the current review, it was evident that surgeons are now using facilities such as small-gauge vitrectomy and pharmaceutical substances including ocriplasmin, which enhance macular hole closure rates and near visual acuity levels. Teaching has been done to patients/clients and organized follow-ups as part of the organizational care to improve quality of life as perceived by patients from follow-up questionnaires representing a significant improvement in visual function and activities.Conclusion: this paper outlines that patients with IMH require a structured and coordinated, cross-professional approach to its management in conjunction with contemporary surgery revealing drastic enhancements to visual acuity levels and the overall wellbeing of a patient