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Platelet-rich plasma and macular hole surgery: A clue to their mode of action and the influence of anti-platelet agents

Lookup NU author(s): Dr Alan Bagnall, Dr Katherine Talks, Roxane Hillier

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Abstract

© The Author(s) 2022. Purpose: To present a case of refractory full-thickness macular hole (FTMH), in which autologous platelet-rich plasma (aPRP) was used on two consecutive occasions, and associated with successful closure only after complete cessation of anti-platelet therapy. Methods: Interventional case report. Results: A 63-year-old male with Alport syndrome underwent pars plana vitrectomy with internal limiting membrane peeling and gas for a large FTMH. The patient was on systemic anti-platelet agents for coronary disease. Post-operatively, the FTMH remained open and repeated surgery, augmented with aPRP, was performed. Although a thick pre-retinal coagulum was evident on optical coherence tomography on day one post-surgery, the second surgery failed. Ultimately, successful aPRP-augmented surgical closure of the FTMH was achieved only after complete cessation of systemic anti-platelet agents. Conclusion: Appropriate management of anti-platelet therapy may be relevant when planning aPRP use, though further large-scale studies are needed to assess the precise effect of anti-platelet therapy on the efficacy of aPRP, and to confirm the potential role of aPRP in patients with Alport syndrome.

Publication metadata

Author(s): D'Alterio FM, Ferrara M, Bagnall A, Talks KL, Hillier RJ

Publication type: Article

Publication status: Published

Journal: European Journal of Ophthalmology

Year: 2023

Volume: 33

Issue: 4

Pages: NP111-NP114

Print publication date: 01/07/2023

Online publication date: 13/04/2022

Acceptance date: 22/03/2022

ISSN (print): 1120-6721

ISSN (electronic): 1724-6016

Publisher: SAGE Publications Ltd

URL: https://doi.org/10.1177/11206721221093601

DOI: 10.1177/11206721221093601

PubMed id: 35414271

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