MEMBRANE RICH IN GROWTH FACTORS FOR THE TREATMENT OF REFRACTORY MACULAR HOLES AND ITS EFFECTS ON RETINAL VASCULATURE...

Evaluate the safety and efficacy of membrane rich in growth factors (mPRGF) and its effects on retinal vasculature and anatomy in refractory and poor-prognosis macular holes.

Retrospective, interventional, longitudinal, case series, and single-center study conducted at Dr. Elías Santana Hospital, Dominican Republic. Patients with macular hole larger than 400 μm, refractory or with poor prognosis, were treated with posterior pars plana vitrectomy plus adjuvant therapy mPRGF. A total of seven eyes were included: refractory macular hole (n = 6) and traumatic macular hole (n = 1). The anatomical closure was evaluated by optical coherence tomography and foveal avascular zone, and foveal density was measured with optical coherence tomography angiography pre- and postsurgery. Also, the corrected visual acuity was compared pre- and postintervention.

A total of seven eyes were intervened and a surgical-anatomic closure rate was 85.7%. The average corrected visual acuity resulted in an improvement of more than six lines in Snellen notation that was statistically significant ( P = 0.036). Foveal avascular zone and foveal density showed a decrease ( P = 0.002) and increase ( P = 0.043), respectively, after surgery.

In conclusion, this clinical research provides compelling evidence supporting the efficacy and safety of mPRGF in achieving the anatomical closure of refractory or traumatic macular holes larger than 400 μm. Notably, mPRGF treatment demonstrated significant improvements in patients' visual acuity and contributed to the restoration of normal retinal vasculature. These exciting results pave the way for the potential utilization of mPRGF as a reproducible and cost-effective adjuvant therapy in the surgical management of macular holes.