Лечение заболеваний макулы: резюме ключевых рандомизированных клинических исследований

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.

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