helmholtzeyeinstituteРоссийский офтальмологический журналRussian Ophthalmological Journal2072-00762587-5760Real time Publishers10.21516/2072-0076-2021-14-4-137-148helmholtzeyeinstitute-799Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEWSЛечение заболеваний макулы: резюме ключевых рандомизированных клинических исследованийTreatment of macular diseases: an overview of key randomized clinical trialshttps://orcid.org/0000-0001-5752-8883БобыкинЕ. В.BobykinE. V.

Евгений Валерьевич Бобыкин — канд. мед. наук, доцент, доцент кафедры офтальмологии

ул. Репина, д. 3, Екатеринбург, 620028

Evgeny V. Bobykin — Cand. of Med. Sci., professor associate, assistant professor of chair of ophthalmology

3, Repin St., Yekaterinburg, 620028

oculist.ev@gmail.comhttps://orcid.org/0000-0002-6331-1987МорозоваО. В.MorozovaO. V.

Ольга Викторовна Морозова — врач-офтальмолог, соискатель кафедры офтальмологии

ул. Репина, д. 3, Екатеринбург, 620028

 

Olga V. Morozova — ophthalmologist, PhD student, chair of ophthalmology

3, Repin St., Yekaterinburg, 620028

https://orcid.org/0000-0001-5536-3181БересневаН. С.BeresnevaN. S.

Надежда Сергеевна Береснева — клинический ординатор кафедры офтальмологии

ул. Репина, д. 3, Екатеринбург, 620028

Nadezhda S. Beresneva — clinical resident of chair of ophthalmology

3, Repin St., Yekaterinburg, 620028

ФГБОУ ВО «Уральский государственный медицинский университет» Минздрава РоссииРоссияUral State Medical UniversityRussian Federation202104012022144137148Copyright © Бобыкин Е.В., Морозова О.В., Береснева Н.С., 20222022Бобыкин Е.В., Морозова О.В., Береснева Н.С.Bobykin E.V., Morozova O.V., Beresneva N.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://roj.igb.ru/jour/article/view/799

Рандомизированные клинические исследования предоставили офтальмологам ценную информацию о естественном течении и стратегиях лечения распространенных заболеваний сетчатки с позиций медицины, основанной на доказательствах. В данном обзоре предпринята попытка систематизировать наиболее значимые из них. Выбраны 42 рандомизированных исследования, проведенных с 1979 по 2019 г. и посвященных лечению возрастной макулярной дегенерации (AREDS 1, AREDS 2, ANCHOR, MARINA, PrONTO, CATT, IVAN, VIEW 1, VIEW 2, EVEREST II, PLANET, SEVEN-UP, ALTAIR, HAWK, HARRIER), хориоидальной неоваскуляризации различной этиологии (миопической, поствоспалительной, на фоне ангиоидных полос и др. — RADIANCE, REPAIR, MYRROR, MINERVA), диабетических поражений глаз (диабетической ретинопатии и диабетического макулярного отека — ETDRS, протоколы B, I, S и T DRCR.net, RISE, RIDE, VIVID-DME, VISTA-DME, MEAD, FAME), а также окклюзий вен сетчатки (BVOS, CVOS, SCORE-CRVO, SCORE-BRVO, BRAVO, CRUISE, GALILEO, COPERNICUS, VIBRANT) и ретинопатии недоношенных (CRYO-ROP, ETROP, RAINBOW). Приводятся основные данные, обосновывающие с позиций доказательной медицины эффективность и безопасность применения таких методов лечения, как антивазопролиферативная и фотодинамическая терапия, лазерная коагуляция сетчатки, криотерапия, использование кортикостероидов и витаминно-минеральных комплексов. Их результаты сформировали парадигмы ведения заболеваний и оказали определяющее влияние на развитие современной ретинологии. Для большей наглядности представлена таблица, в которой обобщена краткая информация о каждом из рассмотренных рандомизированных клинических исследований.

Macular diseases are traditionally a serious issue in ophthalmology, which has great social impact due to widespread occurrence and significant vision loss, often irreversible. Over the past few decades, the possibilities for the diagnosis and treatment of pathologies of the retina and choroid have been significantly expanded. Randomized clinical trials provided ophthalmologists with valuable information on the natural course and treatment strategies of common retinal diseases from the viewpoint of evidence-based medicine. However, due to the large number of trials conducted, it is often difficult to make an adequate choice of data to be used in daily practice. In this review, we systematize the most valuable randomized clinical trials. To this end, we selected 42 randomized clinical studies conducted between 1979 and 2019 and focused on the treatment of age-related macular degeneration (AREDS 1, AREDS 2, ANCHOR, MARINA, PrONTO, CATT, IVAN, VIEW 1, VIEW 2, EVEREST II, PLANET, SEVEN-UP, ALTAIR, HAWK, HARRIER), choroidal neovascularization of multiple etiology (myopic, post-inflammatory, angioid-streak-related, etc. — RADIANCE, REPAIR, MYRROR, MINERVA), diabetic eye lesions (diabetic retinopathy and diabetic macular edema — ETDRS, DRCR.net Protocols B, I, S and T, RISE, RIDE, VIVID-DME, VISTA-DME, MEAD, FAME), retinal vein occlusions (BVOS, CVOS, SCORE-CRVO, SCORE-BRVO, BRAVO, CRUISE, GALILEO, COPERNICUS, VIBRANT), as well as retinopathy of prematurity (CRYO-ROP, ETROP, RAINBOW). The review summarizes the main results of these studies, which confirm the effectiveness and safety of such treatment methods as antiVEGF and photodynamic therapy, retinal laser photocoagulation, cryotherapy, corticosteroids and nutraceuticals from the viewpoint of evidence-based medicine. For greater clarity, we provide a table summarizing information on each of the randomized clinical trials considered.

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