Methods for monitoring the effectiveness of direct-acting anticoagulants in diabetic retinopathy

Abstract

The use of anticoagulants is the basis for the treatment of many diseases that cause the development of arterial and venous thrombosis. One such disease is diabetic retinopathy. There is still no consensus on which way to control the effectiveness of these drugs is the best. That is why there is an active search for specific biomarkers that reflect the quality of the treatment. To this end, we analyzed scientific papers that presented the results of various types of laboratory diagnostics aimed at studying the use of various anticoagulants in the treatment of diabetic retinopathy. The analysis of scientific publications was carried out in the information databases PubMed and eLibrary. The review used works containing a description of the main groups of anticoagulants and methods of laboratory control of their use, published over the past 30 years. Review articles, results of experimental studies, monographs, study guides and dissertations were analyzed. It is well known that anticoagulants are divided into two main groups - direct and indirect. In modern clinical practice, mainly direct ones are used. To control their effectiveness, traditional methods for determining the coagulogram are mainly used, but more and more often, the authors resort to a more detailed study of the rheological properties of blood (determination of anti-Xa activity, platelet aggregation using inductors, activity of clotting factors). At the same time, it remains promising to determine their effect on the concentration of pro-inflammatory cytokines and growth factors in the blood serum and lacrimal fluid in diabetic retinopathy. Thus, it can be concluded that there is no consensus on which research methods most accurately reflect the effect of anticoagulants on the hemostatic system and indicators of inflammatory activity in various diseases, in particular in diabetic retinopathy. Therefore, it is necessary to study in more detail what laboratory parameters can change under the influence of these drugs.