title: [Effect of autologous platelet concentrates on the anatomical and functional outcome of late stage macular hole surgery: A retrospective analysis].
abstract: BACKGROUND
  The macular hole (MH) is a disorder of the visual center of the retina in humans. An untreated MH leads to loss of central visual acuity and reading ability. Surgery for early-stage macular holes has been very successful for many years and leads to very good anatomical and functional results. Despite continuous improvement of surgical procedures, the outcome for the later stages of MH is still unsatisfactory.
  
  
  METHODS
  In a retrospective analysis, we investigated the effect of autologous platelet concentrates in patients presenting later stages of MHs (stage III-IV) with respect to anatomic success (hole closure) and recovery of vision. The application of platelets was performed during retinal surgery (pars plana vitrectomy, ppV). In addition, selected platelet concentrates were qualitatively analysed for growth factors and platelet adhesion.
  
  
  RESULTS
  In the first group, 74% of the patients showed a good anatomical macular hole closure. The analyses of the platelet concentrates indicated a possible wound-healing effect due to growth factors (e.g. the platelet-derived growth factor, PDGF) and lesser to the ability of the platelets to adhere after ristocetin administration. Further optimization of the production process of platelet concentrates and of the surgical procedure in the second group of patients showed an increase of the anatomical success (92%) and a very rapid increase of visual acuity within six weeks.
  
  
  CONCLUSIONS
  In the past, the primary goal of MH surgery was to optimize the surgical procedures. Only few concepts focused on wound healing. Based on our data, we postulate the use of autologous platelet concentrates in MH surgery as a healing concept, which helps to increase the functional success of late-stage macular hole surgery.
authors.affiliation: Klinik für Augenheilkunde, Klinikum Chemnitz gGmbH, Flemmingstraße 2, 09116, Chemnitz, Deutschland. k.engelmann@skc.de.|Institut für Anatomie, Medizinische Fakultät Carl Gustav Carus der TU Dresden, Fetscherstraße 74, Dresden, 01307, Deutschland. k.engelmann@skc.de.
authors.forename: Katrin
authors.initials: K
authors.lastname: Engelmann
authors.affiliation: DRK-Blutspendendienst Nord-Ost gGmbH, Chemnitz, Deutschland.
authors.forename: Uwe
authors.initials: U
authors.lastname: Sievert
authors.affiliation: Bereich Transfusionsmedizin an der Medizinischen Klinik I, Universitätsklinikum Carl Gustav Carus Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.
authors.forename: Kristina
authors.initials: K
authors.lastname: Hölig
authors.affiliation: Klinik für Augenheilkunde, Klinikum Chemnitz gGmbH, Flemmingstraße 2, 09116, Chemnitz, Deutschland.
authors.forename: Dierk
authors.initials: D
authors.lastname: Wittig
authors.affiliation: Klinik für Augenheilkunde, Klinikum Chemnitz gGmbH, Flemmingstraße 2, 09116, Chemnitz, Deutschland.
authors.forename: Sarah
authors.initials: S
authors.lastname: Weßlau
authors.affiliation: Institut für Anatomie, Medizinische Fakultät Carl Gustav Carus der TU Dresden, Fetscherstraße 74, Dresden, 01307, Deutschland.
authors.forename: Stefan
authors.initials: S
authors.lastname: Domann
authors.affiliation: Institut für Klinische Chemie und Laboratoriumsmedizin, Universitätsklinikum Carl Gustav Carus Dresden, 01307, Dresden, Fetscherstr. 74, Deutschland.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Siegert
authors.affiliation: Institut für Anatomie, Medizinische Fakultät Carl Gustav Carus der TU Dresden, Fetscherstraße 74, Dresden, 01307, Deutschland.
authors.forename: Monika
authors.initials: M
authors.lastname: Valtink
mesh_terms: D000368:Aged; D001792:Blood Platelets; D006801:Humans; D008875:Middle Aged; D017713:Platelet Transfusion; D012167:Retinal Perforations / Q000601:surgery*; D012189:Retrospective Studies; D035703:Therapies, Investigational / Q000379:methods*; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy / Q000379:methods*; D014945:Wound Healing / Q000502:physiology
keywords: Autologous platelet concentrate; Macular hole; Surgery; Wound healing