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

Abstract

Anticoagulants are the basis for the treatment of various diseases that induces the development of arterial and venous thrombosis. One such disease is diabetic retinopathy. However, no consensus has been reached regarding the best way to control the effectiveness of these drugs. Thus, active search is ongoing for specific biomarkers that reflect treatment quality. To this end, this study analyzed scientific papers that presented the results of various laboratory diagnostics aimed at examining the use of anticoagulants in the treatment of diabetic retinopathy. PubMed and eLIBRARY.RU were searched for legible studies. The review analyzed studies that describe the main groups of anticoagulants and methods of laboratory control of their use and published in the past 30 years. Review articles, results of experimental studies, monographs, study guides, and dissertations were analyzed. Anticoagulants are divided into direct and indirect. In modern clinical practice, direct ones are mainly used. To control their effectiveness, traditional methods for determining the coagulogram are mainly used; however, increasingly more often, the authors resort to a more detailed study of the rheological properties of the blood, such as determination of anti-X activity, platelet aggregation using inductors, and activity of clotting factors. In addition, determining their effect on the concentration of pro-inflammatory cytokines and growth factors in the blood serum and lacrimal fluid in diabetic retinopathy remains promising. However, no consensus has been established on which research methods most accurately reflect the effect of anticoagulants on the hemostatic system and indicators of inflammatory activity in various diseases, particularly in diabetic retinopathy. Therefore, a detailed analysis of what laboratory parameters can change under the influence of these drugs is necessary.