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Platelet-rich Fibrin Membrane Transplantation for the Treatment of Highly Myopic Macular Hole Retinal Detachment
Guojing Lu1, Siyu Zeng1, Rong Huang2
1Eye Center, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuhan, Hubei Province, China.
Introduction:
Highly myopic macular hole retinal detachment (MHRD) is often associated with a poor prognosis, and there is currently no optimal treatment. Platelet-rich fibrin (PRF), an autologous blood product, has been shown to promote tissue regeneration. This prospective, randomized, controlled study investigated the efficacy of conventional internal limiting membrane (ILM) peeling versus PRF membrane transplantation in highly myopic MHRD.
Methods:
Eyes with highly myopic MHRD were randomly assigned to either a conventional ILM peeling group (IP group, n = 19) or a PRF membrane transplantation group (PMT group, n = 21). The study followed participants for a period of 6 months. The primary outcome measure was macular hole (MH) closure assessed using optical coherence tomography. Secondary outcomes included best-corrected visual acuity (BCVA), central retinal thickness (CRT), superficial vascular density (SVD), deep vascular density (DVD), rate of retinal reattachment, and any complications encountered.
Results:
MH closure was achieved in a significantly greater proportion of eyes in the PMT group (21/21, 100.00%) compared to the IP group (15/19, 78.95%) (P = 0.042). Retinal reattachment was accomplished in all patients (100.00%) within both groups. Except for an insignificant difference in BCVA observed at 1 week post-surgery in the IP group, significant improvements in BCVA and CRT were documented in both groups across all other post-operative time points. Final BCVA (P = 0.040), CRT (P = 0.002), SVD (P = 0.002), and DVD (P = 0.013) were all significantly higher in the PMT group compared to the IP group. No serious complications were identified in either group.
Conclusions:
This study demonstrated the superiority of PRF membrane transplantation compared to conventional ILM peeling in promoting MH closure and enhancing retinal vascular density in patients with highly myopic MHRD. Additionally, PRF membrane transplantation effectively restores retinal reattachment, improves visual function, and increases retinal thickness without introducing additional complications.
Trial Registration Number:
www.
Clinicaltrials:
gov , NCT06200727.
Insights
Platelet-rich fibrin (PRF) membrane transplantation significantly improves macular hole closure and visual acuity in highly myopic macular hole retinal detachment (MHRD) compared to standard treatment. PRF offers a promising, safe, and effective therapeutic option for MHRD patients.
Area of Science:
- Ophthalmology
- Regenerative Medicine
- Retinal Surgery
Background:
- Highly myopic macular hole retinal detachment (MHRD) presents a significant clinical challenge with limited treatment options.
- Platelet-rich fibrin (PRF) is an autologous biomaterial with demonstrated tissue regenerative properties.
Purpose of the Study:
- To compare the efficacy of PRF membrane transplantation against conventional internal limiting membrane (ILM) peeling for treating highly myopic MHRD.
- To evaluate the impact of PRF on macular hole closure, visual acuity, and retinal structure.
Main Methods:
- A prospective, randomized, controlled study involving 40 patients with highly myopic MHRD.
- Participants were assigned to either ILM peeling (IP group, n=19) or PRF membrane transplantation (PMT group, n=21).
- Outcomes assessed included macular hole closure, best-corrected visual acuity (BCVA), central retinal thickness (CRT), and vascular density over 6 months.
Main Results:
- Macular hole closure was achieved in 100% of the PRF group versus 78.95% in the ILM peeling group (P=0.042).
- The PRF group showed significantly better final BCVA (P=0.040), CRT (P=0.002), superficial vascular density (P=0.002), and deep vascular density (P=0.013).
- Retinal reattachment was 100% in both groups, with no serious complications reported.
Conclusions:
- PRF membrane transplantation is superior to conventional ILM peeling for achieving macular hole closure in highly myopic MHRD.
- PRF enhances visual function, retinal thickness, and vascularity, representing a safe and effective treatment modality.
- This study supports PRF as a valuable therapeutic option for improving outcomes in highly myopic MHRD.
